DM LAB TEST REQUESTFORM
Pea Collection Division
456 North 5th Street
Philadelphia, PA19123
Phone (215) 873-2200 or Fax (215) 625-9812
ompany Name: / Contact Person:Address:
Report Copy via email to: Mari Alessi-Kowalski
Telephone: / Failed Hard Copy report send to: Mari Alessi -Kowalski
Fax: / Tech Designer:
Email address: / CC: /
Sample Description: / No. of Samples:
Style Number: / MWI Color #:
Manufacturer Name: / Fiber Content:
PO Number: / Country of Origin:
Testing Associate or Tech Designer: / Fabric Country of Origin:
Proposed Care Instruction: / Washing: Hand or Machine ______
Wash Temperature: Cold, Warm, Hot ______
Cycle: Normal, Gentle ______
Detergent: Regular, Mild ______
Bleaching: Chlorine , Non Chlorine, No Bleach ______
Drying; Tumble dry low/med/high, Line dry or lay flat to dry ______
Ironing low/med/high ______
Dry Clean commercial / professional (solvent P, F, A, Petroleum based etc.) ______
______
Fabric end use:
Dye Type:
Trim , Embellishment or heat seal:
LAB CHOICE:SERVICE REQUIRED:
(Check One)(Check One)
TUV SUD Standard 5 Days
SGS
INTERTEK Rush – 3 Days (40% surcharge)
UL or Certintex
TEST PACKAGE: DESTINATION MATERNITY Pea Collection Test Package
(Check One)
Knit (3 yards fabric / 2 garments) Bras (3 yards fabric / 3 garments)
Knit Lingerie (3 yards fabric / 2 garments) Panties (3 yards fabric / 2 garments)
Woven (3 yards fabric / 2 garments) Sweaters (3 garments)
Woven Lingerie (3 yards fabric / 2 garments) Swimwear (3 yards fabric / 2 garments
Denim (3 garments) Leather(3 yards skin / 2 garments)
CPSIA General Conformity CertificateCPSIA Applicable rules review and GCC under BVCPS GCC services scope. Please provide name, full mailing address, e-mail address and telephone number of the person maintaining test records in support of the certification.
Retest / If yes, previous report number:Other:
**Styles being tested that have a knit belly, knit bra, or lining fabric please send 3 yards of the belly, bra or lining fabric at the same time you submit fabric / garments for full testing
**Flammability testing requires an additional yard of fabric per color
*Testing will commence for the ONE proposed wash or dry clean condition advised by the vendor or agent. The vendor/agent must advise the proposed care that will pass all Destination Maternity Corp. required testing and garner the safest legal care wording possible.Failure to provide an appropriate care instruction will result in the need for re-testing until fabric and garments pass DM standards.
THIS TEST REQUEST IS SUBJECT TO THE CONDITIONS OF TESTING SET FORTH ON THE REVERSE SIDE HEREOF.
We request testing under the Destination Maternity Corp.Testing Program and agree that all testing will be carried out subject to the Motherswork Certified Labs scale of approved charges as set forth in the current price list for SGS, Intertek, UL, and TUV SUD. Copies of Destination Maternity Corp. Test reports may not be requested by any other party other than the requesting vendor and Motherswork Inc. Motherswork test reports will be issued in locked PDF format to prevent tampering. Failure to comply with this requirement will result in de-certification of said lab.
Remark: Manufacture Information is required for CPSIA’s General Conformity Certificate
Name of Manufacturer:Mailing Address / Tel No.:
Date of Manufacture (MM/DD/YY):
Place of Manufacture (City/Province/Country):
Date / Authorized Signature
Lab Test Request Form Pea Collection 2014-2015 V3
Lab Test Request Form Pea Collection 2014-2015 V3