i-alert2 certificates · 2018-11-01 · sheet 2 of 3 exf-305 - supplementary ec type exam...

Test Report

Number : TWNC00470017

Authorized by:

On Behalf of Intertek Testing Services Taiwan Limited

K. Y. Liang Director

*THJ0470017* of 27 Intertek Testing Services Taiwan Ltd.

8F., No. 423, Ruiguang Rd., Neihu District, Taipei 11492, Taiwan, R.O.C.

11492 423 8

Tel: (+886-2) 6602-2888 2797-8885 Fax: (+886-2) 6602-2410

Applicant: ITT Goulds Pumps Date : Sep 30, 2015

240 Fall Street Seneca Falls, NY 13148

USA

Sample Description:

One (1) group of submitted samples said to be : Sample Description : I alert

Date Sample Received : Sep 14, 2015 Date Test Started : Sep 16, 2015

Test Conducted:

As requested by the applicant, the submitted sample was dismantled into several material categories and a

composite test was conducted by weight ratio. For details, please refer to attached pages.

Summary:

According to the client’s request, a composite screening test was conducted for the 163 Substances of Very High Concern (SVHC) in the Candidate List promulgated by the European Chemicals Agency (ECHA). The criterion defined

in Article 33 of the REACH regulation for providing information on the safe use of substances in articles is less than

0.1% (w/w). For the submitted sample, the composite test results show the SVHC are less than 0.1% (w/w).

The thresholds and substances of SVHC are defined in Article 7 and 57 of Regulation (EC) No 1907/2006 (REACH Regulation).

According to the REACH regulation, the Candidate List of SVHC is proposed and evaluated by European Chemicals

Agency (ECHA) and may be subject to change in the future. As of Jun 15, 2015, there are total of 163 SVHC in this

list. The applicant should be ready to note the latest list.

Please refer to the following link for further details:

http://echa.europa.eu/chem_data/authorisation_process/candidate_list_table_en.asp

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CLASSIFICATION PRODUCT SPECIFICATION No. DS-17xx-2400-102

REV. 2.12

SUBJECT CLASS 2 BLUETOOTH LOW ENERGY

SINGLE MODE MODULE PAGE 36 of 37

CUSTOMER’S CODE PAN172x / PAN171x

PANASONIC’S CODE ENW89820AxKF / ENW89835AxKF

DATE 08.07.2015

PANASONIC INDUSTRIAL DEVICES EUROPE GMBH www.pideu.panasonic.de

34. EUROPEAN R&TTE DECLARATION OF CONFORMITY

__________________________

Intertek Testing & Certification Limited Todd L. Relyea Intertek House, Cleeve Road, Leatherhead, Surrey, KT22 7SB Certification Officer Tel: +44 (0)1372 370900 Fax: +44 (0)1372 370977 22 April 2016

www.intertek.com Registered No 3272281 Registered Office: Academy Place, 1-9 Brook Street, Brentwood, Essex, CM14 5NQ.

This certificate may only be reproduced in its entirety and without any change, schedule included and is subject to Intertek Testing and Certification’s Conditions for Granting Certification.

Sheet 1 of 3

ExF-305 - Supplementary EC Type Exam Certificate Template Revision 3 June 2013

1. SUPPLEMENTARY EC-TYPE EXAMINATION CERTIFICATE 2. Equipment or Protective System Intended for use in Potentially

Explosive Atmospheres Directive 94/9/EC

3. EC-Type Examination Certificate Number: ITS 15ATEX28248/2 4. Equipment or Protective System: Condition Monitor (i-ALERT) 5. Manufacturer: Goulds Pumps Inc 6. Address: 240 Fall Street; Seneca Falls, NY 13148; USA 7. This supplementary certificate extends EC-Type Examination Certificate Number to apply to equipment or

protective systems designed and constructed in accordance with the specification set out in the Schedule of the said Certificate but having variations specified in the Schedule attached to this certificate and the documents therein referred to.

Intertek Reports 102468742CRT-002a and 102468742CRT-002b, dated 2016-04-08 This Supplementary Certificate shall be held with the original Certificate(s). ITS 15ATEX28248 dated 26 May 2015 ITS 15ATEX28248/1 dated 23 July 2015

SCHEDULE SUPPLEMENTARY EC-TYPE EXAMINATION CERTIFICATE NUMBER ITS 15ATEX28248/2

Intertek Testing & Certification Limited

Intertek House, Cleeve Road, Leatherhead, Surrey, KT22 7SB Tel: + 44 (0)1372 370900 Fax: +44 (0)1372 370977


This Certificate is the property of Intertek Testing and Certification Ltd and is subject to Intertek Testing and Certification’s Conditions for Granting Certification.

Sheet 2 of 3


VARIATION TWO Description of the Variation to the Equipment or Protective System. To permit the following change(s): - 1. CHANGE: NB # from 0575 to 2460 2. CHANGE: MAX AMBIENT from +84°C to +60°C 3. CHANGE: TCODE from T3 to T4 4. CHANGE: TCLASS from T200°C to T135°C Report No.: Intertek Report Ref.: 102468742CRT-002a and 102468742CRT-002b, dated 2016-04-08 The changes have amended the Equipment or Protective System marking/description to be: -

I 1 G Ex ia I Ma

II 1 G Ex ia IIB T4 Ga

II 1 D Ex ia IIIC T135°C Da

-40°C ≤ Ta ≤ +60°C Conditions of Certification:

(a). Special Conditions for safe use

· None (b). Conditions of Manufacture

· None Essential Health and Safety Requirements (EHSR’s)

See original certificate, the listed change to the Equipment or Protective System has not altered compliance. Drawings and Documents

Title Drawing No.: Rev. Level: Date:

ASSEMBLY, MONITOR C10814A 5 3-23-16

SHELL C10813A 4 3/23/16

SCHEDULE SUPPLEMENTARY EC-TYPE EXAMINATION CERTIFICATE NUMBER ITS 15ATEX28248/2

Intertek Testing & Certification Limited

Intertek House, Cleeve Road, Leatherhead, Surrey, KT22 7SB Tel: + 44 (0)1372 370900 Fax: +44 (0)1372 370977


This Certificate is the property of Intertek Testing and Certification Ltd and is subject to Intertek Testing and Certification’s Conditions for Granting Certification.

Sheet 3 of 3


BLACK ELECTRICAL POTTING C10218A_BF 0 09-11-14

CLEAR ELECTRICAL POTTING C10218A_CF 1 09-11-14

BOARD, ASSEMBLY C10220A 5 06/16/15

PCB, Bluetooth-Next Gen i-Alert C10639A 2 06/17/2015

Bluetooth-Next Gen i-Alert B07849A 9A 06/11/15

Upgraded i-Alert board Agency approval Bill of Material B08186A 2 06-16-2015

Installation, Operation, and Maintenance Manual A11173A 1 03/23/2016

This Certificate is for the exclusive use of Intertek's client and is provided pursuant to the agreement between Intertek and its

Client. Intertek's responsibility and liability are limited to the terms and conditions of the agreement. Intertek assumes no

liability to any party, other than to the Client in accordance with the agreement, for any loss, expense or damage occasioned by

the use of this Certificate. Only the Client is authorized to permit copying or distribution of this Certificate and then only in its

entirety. Any use of the Intertek name or one of its marks for the sale or advertisement of the tested material, product or service

must first be approved in writing by Intertek.

Digitally signed by David

Steblein

DN: cn=David Steblein,

o=ITT Goulds Pumps,

ou=VP of Sales to the

Americas,

[email protected]

om, c=US

Date: 2016.08.23 09:01:41

-04'00'

AUTHORIZATION TO MARK

Applicant: Manufacturer:

Address: Address:

Country: Country:

Contact: Contact:

Phone: Phone:

FAX: FAX:

Email: Email:

Goulds Pumps Inc EMCOM, Inc

240 Fall Street

Seneca Falls, NY 13148

62 Columbus Street

Auburn, NY 13021

USA USA

Brad DeCook Michael Kane

(800) 334-9256 ext. 750 (315) 255-5300

NA NA

[email protected] [email protected]

Party Authorized To Apply Mark: Same as Manufacturer

Report Issuing Office: Cortland, NY

Control Number: 5000855 Authorized by:

for Thomas J. Patterson, Certification Manager

This document supersedes all previous Authorizations to Mark for the noted Report Number.

This Authorization to Mark is for the exclusive use of Intertek's Client and is provided pursuant to the Certification agreement between Intertek and its Client. Intertek's responsibility and liability are

limited to the terms and conditions of the agreement. Intertek assumes no liability to any party, other than to the Client in accordance with the agreement, for any loss, expense or damage occasioned

by the use of this Authorization to Mark. Only the Client is authorized to permit copying or distribution of this Authorization to Mark and then only in its entirety. Use of Intertek’s Certification mark is

restricted to the conditions laid out in the agreement and in this Authorization to Mark. Any further use of the Intertek name for the sale or advertisement of the tested material, product or service must

first be approved in writing by Intertek. Initial Factory Assessments and Follow up Services are for the purpose of assuring appropriate usage of the Certification mark in accordance with the agreement,

they are not for the purposes of production quality control and do not relieve the Client of their obligations in this respect.

Intertek Testing Services NA Inc.

545 East Algonquin Road, Arlington Heights, IL 60005

Telephone 800-345-3851 or 847-439-5667 Fax 312-283-1672

This authorizes the application of the Certification Mark(s) shown below to the models described in the Product(s)Covered section when made in accordance with the conditions set forth in the Certification Agreement and ListingReport. This authorization also applies to multiple listee model(s) identified on the correlation page of the ListingReport.

This document is the property of Intertek Testing Services and is not transferable. The certification mark(s) may beapplied only at the location of the Party Authorized To Apply Mark.

Page 1 of 4 ATM for Report 101778753CRT-008 ATM Issued: 28-Apr-2016

ED 16.3.15 (1-Jan-13) Mandatory


Standard(s):

Product:

Models:

Intrinsically Safe Apparatus and Associated Apparatus for Use in Class I, II, and III, Division 1, Hazardous

(Classified) Locations [UL 913, Eight Edition, Dated 6 December 2013]

Explosive Atmospheres - Part 0: Equipment - General Requirements [UL 60079-0, Sixth Edition, Dated 26

July 2013]

Explosive Atmospheres - Part 11: Equipment Protection by Intrinsic Safety "i" [UL 60079-11, Sixth Edition,

Dated 15 February 2013, Revised 28 March 2014]

Intrinsically Safe and Non-Incendive Equipment for Use in Hazardous Locations [CSA-C22.2 No. 157-92,

Third Edition, General Instruction No. 1: June 1992, Update No. 2: June 2003 (Reaffirmed 2012)]

Explosive Atmospheres - Part 0: Equipment - General Requirements [CSA-C22.2 No. 60079-0:11,

Second Edition, December 2011]

Explosive Atmospheres - Part 11: Equipment Protection by Intrinsic Safety "i" [CSA-C22.2 No. 60079-

11:14, Second Edition, February 2014]

Condition Monitor

For Use in:

USA:

Class I, II, III; Division 1; Groups C, D, E, F, G

Class I; Zone 0, AEx ia IIB Ga (Groups C & D)

Canada:


Ex ia IIB Ga (Groups C & D)

i-ALERT




Applicant: Manufacturer:

Address: Address:

Country: Country:

Contact: Contact:

Phone: Phone:

FAX: FAX:

Email: Email:

This Authorization to Mark is for the exclusive use of Intertek's Client and is provided pursuant to the Certification agreement between Intertek and its Client. Intertek's responsibility and liability are

limited to the terms and conditions of the agreement. Intertek assumes no liability to any party, other than to the Client in accordance with the agreement, for any loss, expense or damage occasioned

by the use of this Authorization to Mark. Only the Client is authorized to permit copying or distribution of this Authorization to Mark and then only in its entirety. Use of Intertek’s Certification mark is

restricted to the conditions laid out in the agreement and in this Authorization to Mark. Any further use of the Intertek name for the sale or advertisement of the tested material, product or service must

first be approved in writing by Intertek. Initial Factory Assessments and Follow up Services are for the purpose of assuring appropriate usage of the Certification mark in accordance with the agreement,

they are not for the purposes of production quality control and do not relieve the Client of their obligations in this respect.

Intertek Testing Services NA Inc.

545 East Algonquin Road, Arlington Heights, IL 60005

Telephone 800-345-3851 or 847-439-5667 Fax 312-283-1672

Control Number: 5000855 Authorized by:

for Thomas J. Patterson, Certification Manager

This document supersedes all previous Authorizations to Mark for the noted Report Number.

[email protected] [email protected]

Party Authorized To Apply Mark: Same as Manufacturer

Report Issuing Office: Cortland, NY

Brad DeCook Sandra Moeller

(800) 334-9256 ext. 750 (440) 352-8961

NA NA

Goulds Pumps Inc TT Electronics

240 Fall Street

Seneca Falls, NY 13148

3700 Lane Road

Perry, OH 44081

USA USA

This authorizes the application of the Certification Mark(s) shown below to the models described in the Product(s)Covered section when made in accordance with the conditions set forth in the Certification Agreement and ListingReport. This authorization also applies to multiple listee model(s) identified on the correlation page of the ListingReport.

This document is the property of Intertek Testing Services and is not transferable. The certification mark(s) may beapplied only at the location of the Party Authorized To Apply Mark.




Standard(s):

Product:

Models:

Intrinsically Safe Apparatus and Associated Apparatus for Use in Class I, II, and III, Division 1, Hazardous

(Classified) Locations [UL 913, Eight Edition, Dated 6 December 2013]

Explosive Atmospheres - Part 0: Equipment - General Requirements [UL 60079-0, Sixth Edition, Dated 26

July 2013]

Explosive Atmospheres - Part 11: Equipment Protection by Intrinsic Safety "i" [UL 60079-11, Sixth Edition,

Dated 15 February 2013, Revised 28 March 2014]

Intrinsically Safe and Non-Incendive Equipment for Use in Hazardous Locations [CSA-C22.2 No. 157-92,

Third Edition, General Instruction No. 1: June 1992, Update No. 2: June 2003 (Reaffirmed 2012)]

Explosive Atmospheres - Part 0: Equipment - General Requirements [CSA-C22.2 No. 60079-0:11,

Second Edition, December 2011]

Explosive Atmospheres - Part 11: Equipment Protection by Intrinsic Safety "i" [CSA-C22.2 No. 60079-

11:14, Second Edition, February 2014]

Condition Monitor

For Use in:

USA:


Class I; Zone 0, AEx ia IIB Ga (Groups C & D)

Canada:


Ex ia IIB Ga (Groups C & D)

i-ALERT

