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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

Bis(2-ethylhexyl) phthalate (DEHP)

1000 ppm

N

 

 

 

Butyl benzyl phthalate (BBP)

1000 ppm

N

 

 

 

Dibutyl phthalate (DBP)

1000 ppm

N

 

 

 

Diisobutyl phthalate (DIBP)

1000 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 is in accordance to RoHS 2 2011/65/EU and commission directive (EU) 2015/863. I also certify that we have implemented processes to ensure the accuracy of the data provided for the products we manufacture, and methods of verifying and auditing the information acquired through our supply chain, as necessary.

Certified By: PBC Linear
Title: Quality Manager
Date: 12/04/2015

 

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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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