To the Chairman of the Identification & Labeling Committee

Form X-1Date:

To the Chairman of the Identification & Labeling Committee

Japan BioPlastics Association

①Company name:

②Representative name:㊞[seal]

③Person in charge:

Name:

Department:

Address:

Postcode:

④Telephone:

Fax:

E-mail:

Application for Use of the GreenPla Logo (New / Renewal / Amendment) (Main/Secondary)

In relation to the abovementioned matter, we request the issuance of written permission for use as follows, having appended the necessary data.

1. Name of the GreenPla / (Accreditation serial number)
2. Raw materials of which the product is composed
(The names of all raw materials (substance names) must be provided)
(In case of class A material, it’s supplier might be required to disclose, if necessary.)
Please place a circle in the remarks box corresponding to the main biodegradable plastic (the one with the highest content). / Raw material name / Content (% by weight) / PL No. / Remarks
Note: With regard to the raw material name, please give the PL name or substance name as specified on the PL, and please ensure that you also specify the PL No. All components and materials must be registered on the PL. If a raw material is the focus of a current application for registration on the PL, please record this in the remarks column.
3. Content of specified elements
Please give the value measured using an analytical method with a valid degree of precision or a legitimate estimated value. Please append an analysis report or materials demonstrating the grounds for the estimated value. / Element name / Content (ppm) / Element name / Content (ppm) / Element name / Content (ppm)
Cd / Hg / Zn
Pb / Cu /

Mo

Cr / Se / F
As / Ni
4. Formation (processing) conditions, etc.
(If there are any special notes regarding the formation (processing) method for the material, please write these here)
5. Main purpose
Please circle the relevant response / Stationery Packaging Container Daily necessities
Agriculture/Horticulture Civil/Architecture
Other ( )
6. Logo usage method
7. Indication of compostability
If there will be a label indicating this, please append materials that will serve as proof of this / Will be indicated Will not be indicated

Notes: (i) Please submit two applications: the main application and the secondary application

(ii) Please do not complete ①②③④on the secondary application

* The content of this form will only be published within the Identification Committee’s Logo Management Subcommittee in the event that the GreenPla becomes the focus of product management by the Logo Management Subcommittee in order to maintain GreenPla identification labelling functions.