JDW non use certification Ver 1 0 e 20120401 by tJpe17BZ

VIEWS: 1 PAGES: 6

									ATT: Japan Display West Inc.                                                      Date (YYYY/MM/DD)
         Certificate of Non-use of Environmentally Controlled Substances
                                                                           Company Name:
                                                                        Responsible Person:
                                                                                     E-mail:
                                                                     Authorized Signature:

We hereby certify that ANY material, where usage has been prohibited according to "Standards of Environmentally
Controlled Substances for Japan Display West Inc." are not contained in any parts, semi-finished units (unit parts) or
packaging materials sold to Japan Display West Inc. We submit "Environment-related substances survey form",
"Survey Response Tool" and "Analysis Reports" as evidence. In case of unit parts, we also submit "Unit Component
List" and "Analysis Report Check List."
1. Parts/Unit parts
                      Part Description:                                       JDW Part No.:
                                                                             Production Plant:

2. Is any coated wire or recycled resin used?
      If yes, please fill out following "Sub-part Name," "Material Name," "Raw Material Manufacturer," "Sony GP
      Certification" and "Green Book No." for raw material manufacturer.
            Yes       Sub-part Name:                                   Sony GP Certification:      Yes        No
                      Material Name:                                    Green Book No.:
           Raw Material Manufacturer:
           No

3. Component list
 No.      Parts Name         Model Number          JDW Code         Manufacturer Name Amount           Unit   Procuring Type    Unit Procuring Type
  1                                                                                                                             p    Procured
  2                                                                                                                             m Supplied
  3                                                                                                                             mm
  4                                                                                                                             g
  5                                                                                                                             mg
*If needed more rows or in case of unit parts, please fill in another attached sheet "Unit Component List."

4. Is any electroless nickel plating used?
           Yes        Name of the manufacturer/Product Number:
                      Lead content (ppm) as specified by the manufacturer's simulation:                                 ppm
           No

5. Is any Polyvinyl chloride "PVC", Brominated Flame Retardants "BFR" or Chlorinated Flame Retardants "CFR" used?
      A. Is any PVC used?                              Yes              No
      B. Is any BFR used?                              Yes              No
      C. Is any CFR used?                              Yes              No
      D. If any above substances are used, whether satisfied with JDW requirements.
                 Satisfied with JDW requirements.      Not satisfied with JDW requirements.   There is no requirement.

Banned Substances Group in Japan Display West Inc.
      For details, please see "Standards of Environmentally Controlled Substances for Japan Display West Inc."
No.                Substances Group                   CAS No.     No.                Substances Group               CAS No.
 1  Cadmium and cadmium compounds *1                     -        11    Dibutyltin (DBT) compounds        *1           -
 2  Lead and lead compounds                *1            -        12    Dioctyltin (DOT) compounds                     -
 3  Mercury and mercury compounds          *1            -        13    Asbestos                                       -
 4  Hexavalent chromium compounds          *1            -        14    Specific azo compounds                         -
    Polychlorinated biphenyls (PCB),                              15    Formaldehyde                                 50-00-0
  5 polychlorinated naphthalenes (PCN),                    -            Specific benzotriazole
    polychlorinated terphenyls (PCT)                              16    2-(3',5'-Di-tert-butyl-2'-                  3846-71-7
  6 Short-chain chlorinated paraffins (SCCP)               -            hydroxyphenyl)benzotriazole
  7 Polyvinyl chloride (PVC) and PVC blends*1              -      17    Dimethyl fumarate (DMF)                      624-49-7
  8 Polybrominated biphenyls (PBB)                         -      18    Beryllium oxide                             1304-56-9
                                                                  19    Cobalt dichloride                           7646-79-9
  9 Polybrominated diphenylethers (PBDE)                   -
    (including decabromodiphenyl ether                            20    Hydrofluorocarbon (HFC),                        -
    Trisubstituted organotin compounds                                  Perfluorocarbon (PFC)
 10 (including tributyltin (TBT) compounds and             -      21    Ozone depleting substances (ODS)                -
    triphenyltin (TPT) compounds)                                 22    Perfluorooctane sulfonates (PFOS)               -

*1: Please see "Standards of Environmentally Controlled Substances for Japan Display West Inc." about "Banned uses (Level 1)"
    and "Exemptions."

Additional remarks:




                                                                                                      Issued on April 1, 2012
ATT: Japan Display West Inc.                                                  Date

                                              Company Name
Unit Component List                           Part Description
                                               JDW Part No.
                                              Production Plant

                                                                                                      Procurin
No.     Parts Name         Model Number          JDW Code Manufacturer NameAmount Unit
                                                                                                         g
  1
  2
  3
  4
  5
  6
  7
  8
  9
 10
 11
 12
 13
 14
 15
 16
 17
 18
 19
 20
 21
 22
 23
 24
 25
 26
 27
 28
 29
 30
 31
 32
 33
 34
 35
 36
 37
 38
 39
 40
 41
 42
 43


Note:
Notwithstanding whether the part has its code or not, please input components of unit. You can add more lines if
necessary. Any formats will be OK if it includes the required information: parts name, model number, JDW code,
manufacturer name, amount, unit and procuring type.
Procured    p
Supplied    m
           mm
            g
           mg
ATT:Japan Display West Inc.                                                    Date (YYYY/MM/DD)              2012/04/01

         Certificate of Non-use of Environmentally Controlled Substances
                                                                         Company Name: ABC Corporation
                         Sample                                       Responsible Person: Japan Taro
                                                                                   E-mail: Taro-Nippon@abc.co.jp
                                                                   Authorized Signature:

We hereby certify that ANY material, where usage has been prohibited according to "Standards of Environmentally
Controlled Substances for Japan Display West Inc." are not contained in any parts, semi-finished units (unit parts) or
packaging materials sold to Japan Display West Inc. We submit "Environment-related substances survey form",
"Survey Response Tool" and "Analysis Reports" as evidence. In case of unit parts, we also submit "Unit Component
List" and "Analysis Report Check List."
1. Parts/Unit parts
                      Part Description: LED Unit                           JDW Part No.: 1-483-414-12
                                                                          Production Plant: Tottori Plant

2. Is any coated wire or recycled resin used?
If yes, please fill out following "Sub-part Name," "Material Name," "Raw Material Manufacturer," "Sony GP Certification"
and "Green Book No." for raw material manufacturer.
            Yes        Sub-part Name: PL Frame                        Sony GP Certification:      Yes         No
                        Material Name: Polycarbonate (PC)             Green Book No.: R4740028
            Raw Material Manufacturer: XYZ Co., Ltd.
            No

3. Component list
No.     Parts Name       Model Number      JDW Code Manufacturer Name Amount           Unit   Procuring Type                     Unit Procuring Type
  1                                                                                                                              p    Procured
  2                                                                                                                              m Supplied
  3             In case of unit parts, please fill in another attached sheet, "Unit Component List."                             mm
  4                                                                                                                              g
  5                                                                                                                              mg
*If needed more rows or in case of unit parts, please fill in another attached sheet "Unit Component List."

4. Is any electroless nickel plating used?
           Yes        Name of the manufacturer/Product Number:                         EFG Co., Ltd./HV123
                      Lead content (ppm) as specified by the manufacturer's simulation:           300                      ppm
           No

5. Is any Polyvinyl chloride "PVC", Brominated Flame Retardants "BFR" or Chlorinated Flame Retardants "CFR" used?
      A. Is any PVC used?                             Yes              No
      B. Is any BFR used?                             Yes              No
      C. Is any CFR used?                             Yes              No
      D. If any above substances are used, whether satisfied with JDW requirements.
                 Satisfied with JDW requirements.     Not satisfied with JDW requirements.   There is no requirement.

Banned Substances Group in Japan Display West Inc.
      For details, please see "Standards of Environmentally Controlled Substances for Japan Display West Inc."
No.               Substances Group                   CAS No.    No.                 Substances Group                CAS No.
 1  Cadmium and cadmium compounds           *1          -       11    Dibutyltin (DBT) compounds           *1          -
 2  Lead and lead compounds                 *1          -       12    Dioctyltin (DOT) compounds                       -
 3  Mercury and mercury compounds           *1          -       13    Asbestos                                         -
 4  Hexavalent chromium compounds           *1          -       14    Specific azo compounds                           -
    Polychlorinated biphenyls (PCB),                            15    Formaldehyde                                    50-00-0
 5 polychlorinated naphthalenes (PCN),                   -            Specific benzotriazole
    polychlorinated terphenyls (PCT)                             16   2-(3',5'-Di-tert-butyl-2'-                     3846-71-7
 6 Short-chain chlorinated paraffins (SCCP)              -            hydroxyphenyl)benzotriazole
 7 Polyvinyl chloride (PVC) and PVC blends  *1           -       17   Dimethyl fumarate (DMF)                         624-49-7
 8 Polybrominated biphenyls (PBB)                        -       18   Beryllium oxide                                1304-56-9
                                                                 19   Cobalt dichloride                              7646-79-9
 9 Polybrominated diphenylethers (PBDE)                  -
    (including decabromodiphenyl ether                           20   Hydrofluorocarbon (HFC), Perfluorocarbon             -
    Trisubstituted organotin compounds                                (PFC)
 10 (including tributyltin (TBT) compounds and           -       21   Ozone depleting substances (ODS)                     -
    triphenyltin (TPT) compounds)                                22   Perfluorooctane sulfonates (PFOS)                    -

*1: Please see "Standards of Environmentally Controlled Substances for Japan Display West Inc." about "Banned uses (Level 1)"
    and "Exemptions."

Additional remarks:




                                                                                                      Issued on April 1, 2012
ATT: Japan Display West Inc.                                                  Date            2012/04/01

                                              Company Name                    ABC Corporation
Unit Component List                           Part Description                   LED Unit
                                               JDW Part No.                    1-483-414-12
       Sample                                 Production Plant                  Tottori Plant

                                                                                                      Procurin
No.      Parts Name         Model Number         JDW Code Manufacturer NameAmount Unit
                                                                                                         g
  1   Double shading tape      P082005           A01454400          A Corporation         1      p    Procured
  2   Prism sheet              P040426           A00880900          B Corporation         1      p    Procured
  3   Diffusion sheet          P074766           A01353800           C Co., Ltd.          1      p    Procured
  4   FPC Unit                 P064906           A01232601                 -              1      p    Procured
  5    FPC                     P083295           A01476600           D Co., Ltd.          1      p    Procured
  6    LED                 NESW008CT-T395        A01316500           E Company            6      p    Supplied
  7    Zener Diode           EDZTE6127B              -               F Company            1      p    Procured
  8    Solder                   M705                 -               G Co., Ltd.         45      mg   Procured
  9   Double adhesive tape     P065118           A01233000           H Co., Ltd.          1      p    Procured
 10   Light guide              P040390           A00878700            I Co., Ltd.         1      p    Procured
 11   Reflective sheet         P065116           A01232800           J Co., Ltd.          1      p    Procured
 12   PL frame                 P040618           A00938102           K Co., Ltd.          1      p    Procured
 13   Double adhesive tape     P065119           A01233100           L Co., Ltd.          1      p    Procured
 14
 15
 16
 17    <Model Number>                                  <JDW Code>
 18    e.g. your company's model number,               Please input JDW part code.
 19         manufacturer's model number,               If no code, please input "-".
 20         JDW model number
 21    If no number, please input "-".
 22
 23
 24
 25
 26
 27
 28
 29
 30
 31
 32
 33
 34
 35
 36
 37
 38
 39
 40
 41
 42
 43


Note:
Notwithstanding whether the part has its code or not, please input components of unit. You can add more lines if
necessary. Any formats will be OK if it includes the required information: parts name, model number, JDW code,
manufacturer name, amount, unit and procuring type.
Procured    p
Supplied    m
           mm
            g
           mg

								
To top