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Pacific Bearing Company's Materials Composition Declaration Form for Equipment

PART / PRODUCT INFORMATION
Part / Product Name ALL PRODUCTS
Part / Product Number ALL PRODUCTS
Part Number Revision
Effective Date of Part Revision

Material/Substance Category Name
Maximum Concentration Value (MCV)
Above MCV? (Y/N)
Intentionally Added? (Y/N)
Provide concentration if available
Describe All Uses (including allowable uses) and Physical Locations
List A Substances
Asbestos
0 ppm
N
Azo Colorants
0 ppm
N
Cadmium/Cadmium Coumpounds
100 ppm
N
Hexavalent Chromium/Hexavalent Chromium Compounds
1000 ppm
N
Lead/Lead Compounds (Lead in PVC insulation)
1000 ppm (300 ppm)
N
Mercury/Mercury Compounds
1000 ppm
N
Include mass of mercury used in lamps (grams)
Class I Ozone Depleting Substances
0 ppm
N
Class II Ozone Depleting Substances
1000 ppm
N
Polybrominated Biphenyls (PBB) and Polybrominated Diphenyls (PBDE)
1000 ppm
N
Polychlorinated Biphenyls (PCB)
0 ppm
N
Polychlorinated Naphthalenes (> 3 Cl)
0 ppm
N
Radioactive Substances
0 ppm
N
Short-chained Chlorinated Hydrocarbons (C10-C13)
0 ppm
N
Tributyl Tin (TBT) and Triphenyl Tin (TPT)
0 ppm
N
Tributyl Tin Oxide
0 ppm
N
List B Substances
Antimony/Antimony Compounds
1000 ppm
N
Arsenic/Arsenic Compounds
1000 ppm
N
Beryllium/Beryllium Compounds
1000 ppm
N
Bismuth/Bismuth Compounds
1000 ppm
N
Brominated Flame Retardants (other than PBB, PBDE)
1000 ppm
N
Nickel
1000 ppm
N
Phthalates
1000 ppm
N
Polyvinyl Chloride (PVC)
1000 ppm
N
Selenium/Selenium Compounds
1000 ppm
N

List C Substances

Carbon Black
0 ppm
N
Crystalline Silica
0 ppm
N
Fluoropolymers (No intentional additon except in part <500 grams (or <5% by weight)
>500 gms or >5% by weight
N
Natural Rubber Latex
0 ppm
N
Polyvinylidene Chloride (PVDC)
0 ppm
N

I certify that I am authorized to declare this Material Composition Declaration Form on behalf of Pacific Bearing Company. I also certify that I have implemented processes to ensure the accuracy of the data provided for the products I manufacture, and methods of verifying and auditing the information acquired through my supply chain, as necessary.

Certified By: PBC Linear
Title: Quality Manager
Date: 01/01/2013

 

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PBC Linear | 6402 Rockton Road, Roscoe, IL 61073 | P. O. Box 6980, Rockford, IL 61125-6980 | Toll-Free (888) 389-6266 | Fax: (815) 389-5790

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