Product Name: (please fill in product name)
Date: August 1, 2011
Masers. Seiko Epson Corporation
(Signature)
Name of responsible person
Posision
Company name
Company address
Phone number
Fax number
Certificate of Regulation Conformation
As described below, we hereby guarantee the regulation state of
(please fill in product name) as the following.
In case of changes in this Certificate, we will promptly contact your company.
Incase the information provided below is inaccurate, and a fine or other penalty is applied to your company or your subsidiary companies as a result of such inaccuracy, your company is free of any liability and we shall resolve the problem at our expense.
Contact person
Division name
E-mail address
Phone number
Fax number
1/8Form-CC07-07-048-AE（Rev.A.12）
Product Name: (please fill in product name)Date: August 1, 2011
1.Regulatory Status
0) Product: Single component Mixture
Please fill chemical name, content (%), CAS RN and REACh (Pre-) Registration # on “Ingredients Certificate”.
1)New Chemical/Existing Chemical:
Name of new substance/CAS# if it is possible
Country / Regulation / StatusJapan / The Law Concerning the Examination and Regulation of Manufacture, Etc. of Chemical Substances (Law No. 117 of 1973, ''Chemical Substance Control Law'' or ''CSCL'') / The substance(s) or all ingredient(s) are listed on the inventory of Existing and New Chemicals(ENCS).
Notified
Meets polymer category to be exempted from notification
New chemical substance(s) in this product
The Industrial Safety and Health Law (Law No. 57 of 1972, ''Industrial Safety and Health Law'' or ''ISHL'') / The substance(s) or all ingredient(s) are listed on ISHL inventory.
Notified
Meets polymer category to be exempted from notification
New chemical substance(s) in this product
USA / TSCA: Toxic Substances Control Act / The substance(s) or all ingredients are listed in TSCA Inventory(ornotified PMNNOC).
Under a Polymer Exemption
Notified the substance(s), but NOC has not been submitted yet.
New chemical substance(s) in this product
Europe / EU Regulation (EC) No.1907/2006
(REACh) / The substance(s) or all ingredients are listed in EINECS / NLP.
Registered (indicates # on page 8)
Manufacture(s) in the EU registered
Only representative registered
Done pre-registration (indicates # on page 8)
Not yet done pre-registration (indicates “Yet” on page 8)
The substance(s) in this product are listed in ELINCS.
The notification is at least 12 years previously.
less than 12 years earlier.
Meets polymer category to be exempted from registration
New chemical substance(s) in this product
Australia / Industrial Chemicals (Notification and Assessment) Act. / The substance(s) or all ingredients are listed in AICS.
Notified alreadySTDLTDPLC, (indicates Certificate # on page 8)
Meets polymer category to be exempted from notification
New chemical substance(s) in this product
Nnanomaterial category: Meets Not meet
Korea / Toxic Chemical Control Law
Industrial Safety and Health Law / The substance(s) or all ingredients are listed in Korean Existing Chemicals.
Notified
Meets polymer category to be exempted from notification
New chemical substance(s) in this product
Philippine / Republic Act No. 6969 / The substance(s) or all ingredients are listed in PICCS.
Notified
Meets polymer category to be exempted from notification
New chemical substances in this product
China / Provisions on the Environmental Administration of New Chemical substances / The substance(s) or all ingredients are already listed in the Inventory of the Existing Chemical Substances in China
Notified, but not registered the Inventory yet
The substance(s) or all ingredients have imported in China before October 14, 2003.
Meets polymer category of simplified notification for polymer
New chemical substance(s) in this product
Canada / CEPA / The substance(s) or all ingredients are listed in DSL.
Meets polymer category to be exempted from notification
The substance(s) listed in NDSL
New chemical substance(s) in this product
Ontario, Canada / Occupational Health and Safety Act / The substance(s) or all ingredients are listed on the Inventory.
New chemical substance(s) in this product
New Zealand / Hazardous Substances and New Organisms Act 1996 / The substance(s) or all ingredients are listed in NZIoC.
New chemical substance(s) in this product
Taiwan / Guidance for Existing Chemical SubstanceNomination (ECN) / The substance(s) or all ingredients are reported already.
Not reported yet
2)Regulated Substances
Country / Regulation / StatusUN / Classification on GHS / Comes under (Type & Class as below) Not come under
ExplosivesNOT AN EXPLOSIVEUnstable EplosiveDivision 1.1Division 1.2Division 1.3Division 1.4Division 1.6
Flammable gasesNot classifiedCategory 1Category 2
Flammable aerosolsNot classifiedCategory 1Category 2
Oxidizing gasesNot classifiedCategory 1
Gases under pressureNot classifiedCompressed gasLiquefied gasRefrigerated liquefied gasDissolved gas
Flammable liquidsNot classifiedCategory 1Category 2Category 3Category 4
Flammable solidsNot classifiedCategory 1Category 2
Self-reactive substances and mixturesNot classifiedType AType BType CType DType EType FType G
Pyrophoric liquidsNot classifiedCategory 1
Pyrophoric solidsNot classifiedCategory 1
Self-heating substances and mixturesNot classifiedCategory 1Category 2
Substances and mixtures which,
in contact water, emit flammable gasesNot classifiedCategory 1Category 2Category 3
Oxidizing liquidsNot classifiedCategory 1Category 2Category 3
Oxidizing solidsNot classifiedCategory 1Category 2Category 3
Organic peroxidesNot classifiedType AType BType CType DType EType FType G
Corrosive to metalsNot classifiedCategory 1
Acute toxicity – OralNot classifiedCategory 1Category 2Category 3Category 4Category 5Classification not possible
Acute toxicity – DermalNot classifiedCategory 1Category 2Category 3Category 4Category 5Classification not possible
Acute toxicity – InhalationNot classifiedCategory 1Category 2Category 3Category 4Category 5Classification not possible
Skin corrosion / irritationNot classifiedCategory 1ACategory 1BCategory 1CCategory 2Category 3Classification not possible
Serious eye damage / eye irritationNot classifiedCategory 1Category 2ACategory 2BClassification not possible
Respiratory sensitizationNot classifiedCategory 1Classification not possible
Skin sensitizationNot classifiedCategory 1Classification not possible
Germ cell mutagenicityNot classifiedCategory 1ACategory 1BCategory 2Classification not possible
CarcinogenicityNot classifiedCategory 1ACategory 1BCategory 2Classification not possible
Reproductive toxicityNot classifiedCategory 1ACategory 1BCategory 2Additional category for effect on or via lactationClassification not possible
Specific target organ systematic toxicity
– Single exposureNot classifiedCategory 1Category 2Category 3Classification not possible
Specific target organ systematic toxicity
– Repeated exposureNot classifiedCategory 1Category 2Classification not possible
Aspiration hazardNot classifiedCategory 1Category 2Classification not possible
Hazardous to the aquatic environment
– AcuteNot classifiedCategory 1Category 2Category 3Classification not possible
Hazardous to the aquatic environment
– ChronicNot classifiedCategory 1Category 2Category 3Category 4Classification not possible
Japan / Chemical Substance Control Law
AClass I or II Specified Chemical Substance
BMonitoring Chemical Substance
CPriority Assessment Chemical Substances (PACS) / ANot contain, evidentlyNot contain, logicallyContains, unintentional logicallyContains, unintentional evidentlyContains, intentional If contains, please show the
BNot contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional evidence as it is compliance
CNot contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional with the law.
Export Control Order
(List No.1 §1~15, List No.2) / Regulated Not regulated
PRTR Law
Specified Class I, Class I or Class II Designated Chemical Substances / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Industrial Safety and Health Law / AProhibition on Manufacture and Permit Required for Manufacturing under Article 55 and 56.
BLabeling under Article 57-1
CNotice (MSDS) under Article 57-2 / ANot contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
BNot contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
CNot contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Ordinance on Prevention of
Hazards Due to Specified
Chemical Substances
Class 2 and 3 substances / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Ordinance on the Prevention of
Organic Solvent Poisoning
Class1, 2, 3 substances / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Fire Service Law / Regulated (Class:) Not regulated
Water Pollution Control Law
Enforcement Orders：substances on Article 2
Enforcement Orders：substances on Article 3-3 / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Regulation of Waste and Public
Cleansing Law
Substance(s) required specific control / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Offensive Odor Control Law
Specific odor substances / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Poisons and Deleterious Substances Control Law
Substances classified “poisons and deleterious substances” / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
USA / TSCA
A: Section 4(a) Final Test Rule
B: Section 5 Proposed SNUR/Final SNUR
C: Section 8(a) PAIR
D: Section 8(d) Health and safety reporting
E: Section 12(b) One-Time Export Notification Regulated
F: Other rule or regulation
Relevant regulation or rule ()
G: EPA planning regulation / ANot contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional the subject substance(s)
BNot contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional the subject substance(s)
CNot contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional the subject substance(s)
DNot contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional the subject substance(s)
ENot contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional the subject substance(s)
FNot contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional the subject substance(s)
GNot contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional the subject substance(s)
USA / Export Administration Regulations / Regulated (Indicates ECCN # / EAR99 on page 8)
Not regulated
Proposition65 / Regulated Not regulated
Europe / Annex VI of CLP regulation, (EU)No1272/2008
(Annex I of Dangerous Substance Directive 67/548/EEC) / Contain(s) any substances which are to be marked with the Symbols / R-phrases according to Annex II / III of 67/548/EEC.
Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional (Indicates Symbols/R-phrase on page 8)
Dangerous Preparation Directive
1999/45/EC
Annex V: Special provisions / Required any Symbols/ R-phrase as preparation Not required
(Please fill the Symbols/ R-phrase: )
Contains at least one sensitizing substance (R43). Not contain
Annex XVII of REACh regulation, (EU)No1907/2006 (76/769/EEC) / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional restricted substance(s)
Annex XIII of REACh regulation, (EU)No1907/2006: Substances meets criteria on, i.e. PBT or vPvB, etc. / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
REACh: Candidate list of authorization substances / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Swiss / ChemG / Please fill in “5. Appendix”, if it requires different label in EU.
China / First import of chemicals and toxic chemicals import and export of environmental regulations
Toxic Chemicals Severely Restricted for Import and Export (2011 ed.) / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Hazardous Chemicals Control Ordinance
Hazardous Chemicals List 2002 Edition / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Korea / Toxic Chemical Control Law
Prohibited Chemical(s)
Toxic Chemical(s)
Restricted Toxic Chemical(s)
Observational Chemical(s) / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Taiwan / Regulation of Labelling and Hazard Communication of Dangerous and Harmful Materials / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional Phase I (1062) substances
Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional Phase II (1089) substances
1/8Form-CC07-07-048-AE（Rev.A.12）
Product Name: (please fill in product name)Date: August 1, 2011
2. Others (Specific Substances)
Substance / StatusEndocrine disrupters / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Carcinogenic substance*1 / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
Nonylphenol, octylphenol and their ethoxylates / Not contain, evidentlyNot contain, logicallyNot containContains, unintentional logicallyContains, unintentional evidentlyContains, intentional
1/8Form-CC07-07-048-AE（Rev.A.12）
Ingredients Certificate of (please fill in product name)Date: August 1, 2011
*1:Carcinogenic substance which are classified as carcinogenic, suspected of having a carcinogenic potential according to the following:
①IARC: Group1, 2A, 2B ②Japan Society for Occupational Health: Category 1, Category 2 ③ACGIH: A1, A2 ④EPA: Category A, B, C
⑤NTP: substances that is known to be human carcinogens, substances that is reasonably anticipated to be human carcinogens
⑥MAK list: MAK 1, 2, 3A, 3B ⑦TRGS 905: substances classified as carcinogenic, mutagenic and reproduction
- Toxicology Information
Study / Methods / Results
Acute oral toxicity / OECD Test Guideline No. 423401
Others () / LD50 [mg/kg]animals []
No data
Acute dermal toxicity / OECD Test Guideline No. 402
Others () / LD50 [mg/kg]animals []
No data
Acute inhalation toxicity / OECD Test Guideline No. 403
Others () / LC50 [mg/L/4hr]animals []
No data
Acute eye irritation / OECD Test Guideline No. 405
Others () / Primary Irritation Index []animals[]
Classification of irritancy []
No data
Acute dermal irritation / OECD Test Guideline No. 404
Others () / Maximum Group Mean Score []animals []
Classification of irritancy[]
No data
Skin sensitization / OECD Test Guideline No. 429
OECD Test Guideline No. 406
Others () / Stimulation Index []
Sensitizer rate [%]
Classification [NegativePositiveNo data]No data
Ames test / OECD Test Guideline No. 471
Others () / [NegativePositiveNo data]
No data
4. MSDS Already submitted attached to this form due to submit [Date:]
- Appendix
If you have any additional information, please fill this space or attach next page.
1/8Form-CC07-07-048-AE（Rev.A.12）
Ingredients Certificate of (please fill in product name)Date: August 1, 2011
I describethe substances which should be disclosed hereunder. If any change in information will occur, I shall inform your company.
Chemical Name / Content(% by weight) / CAS RN / REACh Regulation (if polymer, by monomer)
(Pre-) Registration Number / Regulation (*Cf. No. of Regulation)
(*) [Regulations have to disclose the chemical identities]
1. CSCL; Class I or II / 11. Water Pollution Control Law / 21. Annex XIII of REACh regularion; PBT or vPvB, etc.2. CSCL; Type I, II or III / 12. Waste Disposal and Public Cleansing Law / 22. Candidate list of authorization under REACh
3. CSCL; Priority Assessment Chemical Substances (PACS) / 13. Offensive Odor Control Law / 23. China; Severely Restricted Toxic Chemicals
4. Export Control Order / 14. Poisons and Deleterious Substances Control Law / 24. Chine; Hazardous Chemicals
5. PTTR; Class I or Class II / 15. TSCA; A~F / 25. Korea; TCCL regulated
6. ISHL; Prohibition/ Permit Required / 16. TSCA; G / 26. Taiwan; Dangerous and Harmful Materials
7. ISHL; Labeling / 17. Export Administration Regulations / 27. Endocrine disrupters
8. ISHL; Notice (MSDS) / 18. Proposition 65 / 28. Carcinogen
9. Ordinance on Prevention of Hazards Due to Specified Chemical Substances / 19. Annex VI of CLP regulation (Annex I of 67/548/EEC); Dangerous / 29. Nonylphenol, Octylphenol and their ethoxylates
10. Ordinance on the Prevention of Organic Solvent Poisoning / 20. Annex XVII of REACh regulation (76/769/EEC) ; Restrictions
1/8Form-CC07-07-048-AE（Rev.A.12）