Appendix 6b aw material manufacturer/raw material R supplier of plastic raw material or crude rubber Chemical name of material: Manufacturer: Prohibited substances and additives in plastic and rubber (R6 and R7): Have any additives in the plastic and rubber been classified in accordance with: CarcinogenicH351 (carc 2)/R40 and/or H350 (carc 1A, 1B)/R45 or R49 Yes No MutagenicH340 (muta 1A, 1B)/R46 and/or H341 (muta 2)/R68 Yes No Toxic for reproductionH360 (repr 1A, 1B)/R60 and/or R61 and/or H361 (repr 2)/R62 and/or R63 Yes No Yes No Phthalates? PVC is excempted according to EN71. Aziridine og polyaziridines? Halogenated organic compounds in general (including chlorinated polymers, PVC, chlorinated paraffins, fluoride compounds and flame retardants)? Volatile aromatic compounds in more than 1% by weight? PFOA (perfluoroctanic acid and salts/esters thereof) and PFOS (perfluoro octane sulphonic acid and compounds thereof)? Alkylphenols, alkylphenolethoxylates (or other alkylphenol derivatives? The biocides chlorophenols (their salts and esters), dimethylphumarate? Carcinogenic, mutagen and reproduction damaging compounds (category 1 and 2)? Isothiazolines in more than 0.05% by weight? Compound (3:1) of CMIT/MIT (5 chlorine-2methyl-4-isothiazolin-3-on Cas no 247-500-7); 2-methyl-4-isothiazolin-3-on cas-no. 220-239-6in more than 0.0015% by weight? Substances considered to be endocrine disruptive, category I or II, according to EU reports on endocrine disruptive substances? Yes No Yes No Yes No Yes No Yes No Yes No Are any of the following additives actively been added to plastics/plastic parts and rubber? Pigments and additives based on lead, tin, kadmium, chrome VI, mercury and their compounds? in organic compounds are defined as compounds in which tin is bound directly to the T carbon atom. Yes No Yes No Yes No Yes No Yes No ubstances considered particularly problematic SVHC, ”Substances of very S high concern” according to REACH 1907/2006/EC article 59 (10)? Yes No Substances which meet the criteria for PBT (persistent, bio accumulative and toxic) and vPvB (very persistent and very bio accumulative) og the candidate list of ”particularly problematic substances”? Yes No Overview of additives with name (including CAS no if possible) and producer. Appendix no. _____ (http://ec.europa.eu/enivronment/endocrine/strategy/substances_en.htm) (http://echa.europa.eu/candidate-list-table) (in accordance with the criteria in appendix XIII of the REACH regulation) ( Nordic Ecolabelling of Toys - 2 Nitrosamines in rubber (R8): Does the rubber material contain more than 0.01 mg nitrosamines/kg rubber? Yes No Does the rubber material contain more than 0.1 mg nitrosamine-forming substances/kg rubber? Yes No ( T est report from accredited laboratory including test results as specified in NS-EN 12868 or equivalent methods. Appendix no. _____ Signature of manufacturer: Date Name of company Telephone Contact person (capital letters) e-mail Contact person (signature) Nordic Ecolabelling of Toys - 2
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