USE WITH DRINKING WATER
Regulation 31 Enquiries,
Tel: +44 (0) 300 068 6400
Email:
Website: www.dwi.gov.uk/drinking-water-products/index.htm
APPLICATION FORM: GENERAL METALLIC CONSTRUCTION PRODUCTS
COMMERCIAL IN CONFIDENCE
Please complete the first two lines of this table – the last line is for DWI use only.Your organisation
Name of your product
* Reference Number : DWI 56.4. / Date received by the DWI :
* - this number will be assigned to your product once DWI has received your completed form.
IMPORTANT NOTES1. This form should be used for applications for the approval of general metallic products that are direct contact with water intended for human consumption under the appropriate regulations within the United Kingdom[1]. Separate forms are available from our website for other product types, including pipe systems & site applied products – http://www.dwi.gov.uk/drinking-water-products/advice-and-approval/index.htm. It does not apply to metallic products that have a non-metallic protective coating on their water contact surfaces. Separate forms are available from our website for other product types – http://www.dwi.gov.uk/drinking-water-products/advice-and-approval/index.htm.
2. Before you start completing this form, please read the special instructions relating to stainless steel products – see Section 2 of this form and Section 3 of Advice Sheet 5.
If you fail to provide all the information necessary it is likely that your application will be delayed.
3. We can only consider products that are offered for sale to UK public or private drinking water suppliers and will be used by them in the provision of drinking water supplies. Unlike the Water Regulations Advisory Scheme we cannot consider for approval products used in building water systems, or approve materials in isolation from their end use.
4. Please make sure you clearly mark any supporting information with the name of your organisation and the name of the product(s).
5. You must accept the responsibility for ensuring that ALL information required has been sent to us, either by yourself or directly by your suppliers. Incomplete applications will be returned to you for amendment and will not be considered by DWI until ALL the required information has been received. DWI cannot process incomplete applications.
6. Please e-mail the completed form, as an MS Word® document, to , together will the Instructions for Use documentation and other supporting information. A scanned copy of the signed declaration must be sent to the email address above.
1. APPLICANT DETAILS
Please complete the following details.
Name of your organisationContact name* & position
Contact address
Postcode
Telephone number
Website
* the person who will be taking responsibility for this application
1.1. CONSULTANT (Optional)
You should note that DWI cannot provide help or consultancy with your application, including help in resolving outstanding issues or omissions in your application documents.
If you intend to use a consultant to help you with your application please complete the following details; this consultant will then be our first point of contact.
Name of organisationContact name*
Contact address
Postcode
Telephone number
* the person who will be dealing with this application
2. PRODUCT DETAILS
Please complete this table with details of your product(s).
Product name Note 1Nature of product - description and function
Nature of alloy, including the main metallic element(s) present
Water types in contact with the product -
raw water / Yes/No
water during treatment / Yes/No
treated water / Yes/No
other (explain)
Which public or private drinking water suppliers will be using this product? Note 2
Surface area of product/volume of water ratio Note 3 / cm2 in contact with 1 litre of water
NOTES
1 – the product must have a unique reference that does not infringe any registered trademark or have the same name(s) as any other approved product(s).
2 – we can only consider products that are offered for sale to UK public and private drinking water suppliers and will be used by them in the provision of drinking water supplies.3 – for pipes calculate this on the basis of the smallest diameter pipe to be approved.
3. MANUFACTURER’S OFFICIAL INSTRUCTIONS FOR USE (IFU)
This is a very important document; your product will be considered, assessed and tested on the basis of its contents and any final approval given makes it a legal requirement for the water supplier[2] to adhere to the instructions given in this document. To avoid any delay to your application please make sure that your IFU is –
· comprehensive and up to date
· specific for the use of your product with water intended for human consumption
· meets the full requirements set out in the current version of our Advice Sheet 2 – see link below
Please complete the table below and include an electronic copy (MS WordÒ format) of the IFU document with this application form.
More detailed advice on the requirements for the IFU is given in Advice Sheet 2 available from our website – http://www.dwi.gov.uk/31/pdf/advicesheet2.pdf
Please read this Advice Sheet before submitting your IFU.
We are submitting a copy of the IFU for use with the product in MS WordÒ electronic format.
IFU Title
Issue date
Issue number
We confirm that this document conforms with the following requirements / Tick to confirm
Has full product name and full contact details
Is specific to the product (or range of related products) for which approval is sought
Is written in English
Has a version/issue number and date of issue as detailed above
Has each page numbered sequentially out of the total number of pages
Is written specifically for water suppliersand in contact with water intended for human consumption
Does not contain reference to use of the product in either building or waste water systems
Does not include either advertising copy/literature or claims of efficacy
Does not include reference to "DWI approval" or give a DWI reference number
Does not include references to foreign standards*
Uses only metric/SI units, other than in product names/descriptions
Includes all pre-commissioning conditions, storage, handling & disposal of waste
Includes all the relevant information specified in Advice Sheet Number 2
Note* - references should be to British Standards (including BS EN standards) where available. If equivalent BS (EN) standards are not available the appropriate requirements should be quoted in full.
4. MANUFACTURER
4.1 Name of Manufacturer and Place of Manufacture
Please provide details of who makes the product and their address, if different from your own.
Name of the manufacturerContact name at the manufacturing site
Address of the manufacturing site
Postcode
Telephone number
Website
4.2 Manufacturing Quality Management System
Please provide details of the quality management systems covering the manufacture and supply of your products.
We confirm that this product is manufactured in accordance with a quality management systemOrganisation & address
Quality management system
ISO 9000 series
In-house procedures / Please provide separate details
Other procedures / Please provide separate details
Certifying body
(responsible for third party auditing of the quality management system)
5. EVIDENCE OF THE PRODUCT’S EFFECT ON WATER QUALITY
Unlike non-metallic materials (e.g. plastics and elastomeric materials) the UK does currently not have an equivalent test standard to BS 6920 for metallic products. BS 7766 was used to determine the release of metals into water, but has now been withdrawn due to issues of reproducibility.
We can, however, consider the results of appropriate testing carried out in member states of the European Union. If copies of the test reports (in English) are provided the DWI may be able to reduce any requirements for testing; copies of test certificates alone will not be considered.
6. PRODUCT FORMULATION
Please supply full details of the composition of the alloy(s) used in the product –
Metallic element / % of alloyComponent 1 :
Alloy :
Component 2 :
Alloy :
Component 3 :
Alloy :
Component 4 :
Alloy :
7. DECLARATION - ALL APPLICANTS
Before we can process your application we need your signed acceptance of the requirements and conditions set out below.
7.1 Payment
Payment Tier 1 is payable upon receipt of an application via invoice. Further payments may be required in order to complete the application process and will be invoiced accordingly.Payment tiers:
Tier 1 (Product Code on invoice DEFRA0023) =£350
Tier 2 (Product Code on invoice DEFRA0024) = £2000
Tier 3 (Product Code on invoice DEFRA0025) = £800
Please tick the relevant box below for payment method.
Payment Method / Tick here
Purchase Order Number : ______
Enclosed Cheque made payable to “DEFRA”
Bank Transfer – Please do not pay until you have been invoiced as the payment needs to match the invoice number.
Sort Code: 60-70-80 Account number:10004777
IBAN: GB84NWBK60708010004777
SWIFT: NWBKGB2L
Quote DWI, your company name, invoice number and product.
Credit / Debit Card (Anything but American Express)
Please do not pay by this method until you have been invoiced
Tel: 01904 455395
Quote DWI and your product and company name and invoice number.
Contact name for billing purposes:
Billing Contact address and Postcode:
Telephone number of Billing dept:
E-mail address of Billing contact:
7.2 The documents submitted with this application
Please confirm, by ticking the appropriate boxes, the documents you are submitting to us.
I confirm that we have submitted - / Tick hereA completed signed and dated application form (this form)* – incomplete or unsigned forms will not be considered
A covering letter
The Instructions for Use (IFU), as an MS Word® file, conforming with Advice Sheet 2
List of suppliers contacted for confidential formulation and/or toxicological Information
Material Safety Data Sheets for each ingredient
Other technical information if relevant
Confirmation that all submitted documents are written in English
Billing Information for Tier 1 payment of £350
7.3 The application process
Please confirm, by ticking the boxes, your agreement to the basic conditions under which all applications for approval are handled.
On behalf of the applicant I confirm that - / Tick hereAny Intellectual Rights relating to the product, its packaging and labelling and any associated trade marks, are held by either the applicant or their suppliers†
This product is designed for use with public drinking water supplies
This product will be sold to water suppliers[3] in England, Wales and/or Northern Ireland
The applicant understands that their name and the name of the product for approval will be placed on the DWI website; other details relating to the application will be treated in confidence. The final outcome of the application (including refusals) will also be placed in the Secretary of State’s “List of Approved Products” published on the website.
The applicant understands that any approval given for the product under Regulation 31 relates only to potential effects on drinking water quality, and will be subject to the conditions detailed overleaf (Section 7.4). It does NOT imply fitness-for-purpose or an endorsement of the product, and no claim of “Drinking Water Inspectorate (DWI) approval” should be made.
The applicant understands that it is their responsibility to ensure that all information required in connection with this application, including that provided in confidence directly to the Inspectorate by a third party, is supplied in the required format and in a timely manner
The applicant understands and accepts that the Inspectorate cannot be held responsible for any losses incurred as a result of delays in the approval process.
The applicant accepts the conditions of approval set out in Section 7.3 overleaf
The relevant Regulations[4] make it a criminal offence, punishable by a heavy fine, knowingly or recklessly to make a false statement in an application for approval.
I confirm that the information given in this application form is true to the best of my knowledge and belief.
Signed
Name / Date
†Note – ticking this box confirms that such suppliers are aware of this application
7.4 Summary of Final Approval Conditions
If your application is successful, approval will be subject to the following conditions –
1. Water suppliers shall be provided with a copy of the Instructions for Use and the approved product is used only in accordance with these.2. The agreement of the Drinking Water Inspectorate (DWI) shall be obtained, in advance and in writing, in respect of any change in the Instructions for Use, the formulation of the approved product, source or identity of raw materials, the manufacturing process, location of manufacture, or quality systems, the designation of the approved product, or the name or ownership of the organisation holding the approval.
3. The producer agrees to undertake any further testing subsequently requested by the Secretary of State. The results of such testing shall be sent to the Secretary of State.
4. The use of either the Authorities’[5] name(s) or logo(s), in respect of any approved product (including on the product or in editorial or advertising copy) is not permitted.
5. Final listing of the approved product will be subject to your written acceptance of these conditions. If we do not receive this within 6 months the approval will lapse.
Approvals are granted for a period of 5 years.
8. FINAL CHECKLIST
Before sending your application form to the DWI, please check once again that you have provided, or arranged for your suppliers to provide, ALL of the following information:1. The product name (this is the name that will be used for any approval recommended after consideration by the DWI).
2. The name of the person to whom future correspondence should be addressed.
3. The name of the manufacturer (if different) and the place of manufacture.
4. An instructions for use (IFU) document conforming fully to the requirements set out in Section 3 of this form
5. For the approval process a 3 tier charging system applies. Please ensure that you have paid the appropriate preliminary fee of £350. Once the initial application has been assessed, most new applications (except low risk products) will receive a follow up invoice of £2000 and for approvals requiring complex testing a 3rd charge of £800 will be invoiced.
IMPORTANT NOTE
The DWI will not consider incomplete applications. Applications that have missing or inadequate information will not be considered by DWI until ALL the information required has been received.
Metallic Construction Products Application Form / Page 1 of 10 / June 2016
[1] Regulation 31 of the Water Supply (Water Quality) Regulations 2016/2010 (England & Wales). There are separate legislative and approval processes for Scotland and Northern Ireland, but the Drinking Water Inspectorate carries out the approval process for the whole of the United Kingdom. Further information on regional requirements can be obtained from the Drinking Water Quality Regulator for Scotland ( PO Box 23598, Edinburgh EH6 6WW or e-mail ), or from Chief Inspector of Drinking Water for Northern Ireland ( DWI (NI), Northern Ireland Environment Agency, Klondyke Building, Gasworks Business Site, Belfast, BT7 2JA or e-mail to ). These three organisations are collectively referred to as “the Authorities”.