TEMP 文档资料 06 QC 06 QC Vendor SVHC Survey for REACH

Vendor SVHC Survey Form for REACH(Authorized-person Sign or Seal)(負責人簽名或蓋章)(Company Stamp/公司章)Please fill in below information請填寫以下資訊：Date日期： / / Vendor code供應商代號： Company name公司名稱： Company Representative公司代表人： Company Representative Title公司代表人職稱： Company Postal Address公司地址： Contact Person聯絡人姓名： Contact Person Title聯絡人職稱： Contact Phone聯絡人電話： Contact E-mail聯絡人E-mail： Contact Postal Address聯絡人地址： Please Select Warranty Application請勾選適用保證範圍：Celxpert Part number加百裕料號： Vender type number供應商料號： Celxpert Model name加百裕機種名稱： Vender parts (component(s) Weight(g) 供应商部件（零件）重量(克)： (g/克)All parts(component)we sold to Celxpert,as list所有我方售予加百裕之部件（零件），如下Vender type number 供應商型號： Vender parts (component(s) Weight(g) 供应商部件（零件）重量(克)： g/克)To Celxpert Energy Co.,Ltd：We hereby represent and warrant that the parts(component(s) will be surveyed in accordance to the list of candidate substance of very high concern (SVHC) of REACH regulation, and we will fill in the weight of substance used and other relevant information into the form shown below. Documentation and test data that demonstrate specific actions by the seller to verify compliance must be kept on file and made available on request. This includes documentation and data from the sellers supply chain(s). Upon request by Celxpert, the seller will provide supporting documentation and data to show the accuracy of the information entered into the form.Should we breach warranty. it shall reimburse Celxpert,including the reasonable attomeys fee, for the damages incurred to the extent of the amount appropriate under the applicable laws.此致加百裕工業股份有限公司：我們特此代表並保證所有售予加百裕之部件(零件)，針對歐盟REACH規章高度關注物質(substance of very high concern, SVHC)候選清單進行調查，並將添加之使用量詳細填於下表中。本公司會將供應商驗證為的文件和測試資(包括從供應鏈獲得的文件和據)存檔且妥善保存。當加百裕工業股份有限公司要求時，本公司將提供相關文件及數據，來佐證所提供資訊的符合性及真實性。若因本公司違反前述之保證而致貴公司遭受損失時，本公司願意在法律允許的適當額度內承擔賠償（包括合理律師費）的責任。Item項目Substance Name物質名稱CAS No.Weight (g) (up to 3 decimal places)重量(克) (至三位小數點)Description of Use使用描述1Anthracene(并三苯)120-12-724,4- Diaminodiphenylmethane二氨基二苯甲烷101-77-93Dibutyl phthalate (DBP)( 二丁基)84-74-24Cobalt dichloride(二氯化钴)7646-79-95Diarsenic pentaoxide(五氧化二砷)1303-28-26Diarsenic trioxide(三氧化二砷)1327-53-37Sodium dichromate(重铬酸钠)7789-12-085-tert-butyl-2,4,6-trinitro-m-xylene(二甲苯麝香)(musk xylene)81-15-29Bis (2-ethyl(hexyl)phthalate) (DEHP)( 已基)117-81-710Hexabromocyclododecane(六溴环十二烷)(HBCDD)25637-99-411Alkanes, C10-13, chloro (ShortChain Chlorinated Paraffins)( 烷，叶绿素，氯化石蜡)85535-84-812Bis(tributyltin)oxide(三丁基锡)56-35-913Lead hydrogen arsenate(砷酸氢铅)7784-40-914Benzyl butyl phthalate (BBP)(邻苯二甲酸丁基基酯)85-68-715Triethyl arsenate(三乙基砷酸酯)15606-95-816Anthracene oil(蔥油)90640-80-517Anthracene oil, anthracene paste, distn. Lights(蔥糊，蒸馏)91995-17-418Anthracene oil, anthracene paste, anthracene fraction(蔥)91995-15-219Anthracene oil, anthracene-low90640-82-720Anthracene oil, anthracene paste90640-81-621Pitch, coal tar, high temp.65996-93-222Aluminosilicate Refractory CeramicFibres(铝硅酸盐，纤维)23Zirconia Aluminosilicate, RefractoryCeramic Fibres(硅酸铝耐火陶瓷)242,4-Dinitrotoluene(二硝基甲苯)121-14-225Diisobutyl phthalate(邻苯二甲酸二异丁酯)84-69-526Lead chromate(铬酸铅)7758-97-627Lead chromate molybdate sulphate red (C.I. Pigment Red 104)( 钼酸盐，硫酸盐)12656-85-828Lead sulfochromate yellow(铬酸铅黄)(C.I. Pigment Yellow 34)1344-37-229tris(2-chloroethyl)phosphate(三异丙基乙磺酰)115-96-830Acrylamide(丙烯酰胺)79-06-131Trichloro ethylene(三氯乙烯)79-01-632Boric acid(硼酸)10043-35-333Disodium tetrabotate anhydrous1330-43-434Tetraboron disodium heptaoxide hydrate(七水合四硼酸钠)12267-73-135Sodium chromate(铬酸钠)7775-11-336Potassium chromate(铬酸钾)7789-00-637Ammonium dichromate(重铬酸铵)7789-09-538Potassium dichromate(重铬酸钾)7778-50-939Cobalt (II) sulphate(硫酸盐)10124-43-340Cobalt (II) dinitrate(二硝酸盐)10141-05-641Cobalt (II) carbonate(碳酸盐)513-79-142Cobalt (II) diacetate(乙酰乙酸盐)71-48-7432-Methoxyethanol(2甲氧基乙醇)109-86-4442-Ethoxyethanol(乙二醇单乙醚)110-80-545Chromium trioxide(铬酸)1333-82-046Acids generated from chromiumtrioxide and their oligomers:Chromic acid Dichromic acidOligomers of chromic acid anddichromic acid(低聚物，重铬酸)7738-94-513530-68-2472-Ethoxyethyl acetate (2-EEA)(乙酸乙氧乙酯)111-15-948Strontium chromate(铬酸锶)7789-06-2491,2-Benzenedicarboxylic acid,di-C7-11-branched and linearalkyl esters (DHNUP)(苯二甲酸)68515-42-450Hydrazine(联氨)302-01-27803-57-8511- Methyl-2-pyrrolidone(吡咯烷酮)872-50-4521,2,3-Trichloropropane(三氯丙烷)96-18-4531,2-Benzenedicarboxylic acid,di-C6-8-branched alkyl esters,C7-rich (DIHP)71888-89-654Dichromium tris(chromate)鉻酸鉻24613-89-655Potassium hydroxyoctaoxodizincatedi-chromate氫氧化鉻酸鋅鉀11103-86-956Pentazinc chromate octahydroxide鋅黃(C.I.顏料黃 36)49663-84-557Aluminosilicate Refractory Ceramic Fibres (RCF)硅酸铝耐火陶瓷纤维58Zirconia Aluminosilicate Refractory Ceramic Fibres（Zr-RCF）氧化锆硅酸铝耐火陶瓷纤维59Formaldehyde, oligomeric reaction products with aniline甲醛苯胺共聚物25214-70-460Bis(2-methoxyethyl) phthalate鄰苯二甲酸二甲氧乙酯117-82-8612-Methoxyaniline; o-Anisidine鄰氨基苯甲醚90-04-0624-(1,1,3,3-tetramethylbutyl)phenol, (4-tert-Octylphenol)對特辛基苯酚140-66-9631,2-Dichloroethane1,2-二氯乙烷107-06-264Bis(2-methoxyethyl) ether二乙二醇二甲醚111-96-665Arsenic acid砷酸7778-39-466Calcium arsenate砷酸鈣7778-44-167Trilead diarsenate砷酸鉛3687-31-868N,N-dimethylacetamideN,N-二甲基乙醯胺127-19-569Phenolphthalein酚酞1977-9-8702,2-dichloro-4,4-methylenedianiline (MOCA)4,4-亞甲基雙-2-氯苯胺101-14-471Lead azide Lead diazide疊氮化鉛13424-46-972Lead styphnate2,4,6-三硝基苯二酚鉛15245-44-073Lead dipicrate苦味酸鉛6477-64-174三甘醇二甲醚 1,2-bis(2-methoxyethoxy)ethane (TEGDME; triglyme)112-49-2751，2-二甲氧基乙烷 1,2-dimethoxyethane;ethylene glycol dimethyl ether (EGDME)110-71-476三氧化二硼 Diboron trioxide1303-86-277甲酰胺 Formamide1975/12/778甲磺酸铅(II)溶液 Lead(II)bis(methanesulfonate) 17570-76-279异氰尿酸三缩水甘油酯 TGIC(1,3,5-tris(oxiranylmethyl)-1,3,5-triazine-2,4,6(1H,3H,5H)-trione)2451-62-980替罗昔隆 -TGIC(1,3,5-tris(2S and2R)-2,3-epoxypropyl-1,3,5-triazine-2,4,6-(1H,3H,5H)-trione)59653-74-6814,4-四甲基二氨二苯酮 4,4-bis(dimethylamino)benzophenone(Michlers ketone)90-94-8824,4-亚甲基双(N,N-二甲基苯胺) N,N,N,N-tetramethyl-4,4-methylenedianiline (Michlers base)101-61-183结晶紫 4-4,4-bis(dimethylamino)benzhydrylidenecyclohexa-2,5-dien-1-ylidenedimethylammonium chloride (C.I. Basic Violet 3)548-62-984碱性蓝26 4-4-anilino-1-naphthyl4-(dimethylamino)phenylmethylenecyclohexa-2,5-dien-1-ylidenedimethylammonium chloride (C.I. Basic Blue 26)2580-56-585溶剂蓝4 ,-Bis4-(dimethylamino)phenyl-4 (phenylamino)naphthalene-1-methanol (C.I. Solvent Blue 4)6786-83-086,-二(二甲氨基)苯基-4-甲氨基苯甲醇4,4-bis(dimethylamino)-4-(methylamino)trityl alcohol561-41-187Bis(pentabromophenyl) ether (decabromodiphenylether; DecaBDE)1163-19-588Pentacosafluorotridecanoic acid72629-94-889Tricosafluorododecanoic acid(全氟十二酸)307-55-190Henicosafluoroundecanoic acid(全氟十一烷酸)2058-94-891Heptacosafluorotetradecanoic acid376-06-792Diazene-1,2-dicarboxamide (C,C-azodi(formamide)(甲酰胺)123-77-393Cyclohexane-1,2-dicarboxylic anhydride 1cis-cyclohexane-1,2-dicarboxylic anhydride 2trans-cyclohexane-1,2-dicarboxylic anhydride 3The individual cis- 2 and trans- 3 isomer substances and all possible combinations of the cis- and trans-isomers 1 are coveredby this entry.85-42-7, 13149-00-3, 14166-21-394Hexahydromethylphthalic anhydride 1,Hexahydro-4-methylphthalic anhydride 2,Hexahydro-1-methylphthalic anhydride 3,Hexahydro-3-methylphthalic anhydride 4The individual isomers 2, 3 and 4 (including their cis- and trans- stereo isomeric forms) and all possible combinations of the isomers 1 are covered by this entry(甲基六氢邻苯二甲酸酐)25550-51-0, 19438-60-9, 48122-14-1, 57110-29-9954-Nonylphenol, branched and linear substances with a linear and/or branched alkyl chain with a carbon number of 9 covalently bound in position 4 to phenol, covering also UVCB- and well-defined substances which include any of the individual isomers or a combination thereof-964-(1,1,3,3-tetramethylbutyl)phenol, ethoxylated covering well-defined substances and UVCB substances, polymers and homologues( 乙氧基)-97Methoxyacetic acid(甲氧基乙酸)625-45-698N,N-dimethylformamide68-12-299Dibutyltin dichloride (DBTC)( 二丁基二氯化锡)683-18-1100Lead monoxide (Lead oxide)( 一氧化铅)1317-36-8101Orange lead (Lead tetroxide)( 四氧化三铅)1314-41-6102Lead bis(tetrafluoroborate)13814-96-5103Trilead bis(carbonate)dihydroxide(二氢氧化二甲苯砷)1319-46-6104Lead titanium trioxide(三氧化钛)12060-00-3105Lead titanium zirconium oxide(氧化锆)12626-81-2106Silicic acid, lead salt(硅酸)11120-22-2107Silicic acid (H2Si2O5), barium salt (1:1), lead-doped with lead (Pb) content above the applicable generic concentration limit for toxicity for reproduction Repr. 1A (CLP) or category 1 (DSD); the substance is a member of the group entry of lead compounds, with index number 082-001-00-6 in Regulation (EC) No 1272/200868784-75-81081-bromopropane (n-propyl bromide)( 丙基)106-94-5109Methyloxirane (Propylene oxide)(甲基环氧乙烷)75-56-91101,2-Benzenedicarboxylic acid, dipentylester, branched and linear84777-06-0111Diisopentylphthalate (DIPP)605-50-5112N-pentyl-isopentylphthalate776297-69-91131,2-diethoxyethane(二乙氧基乙烷)629-14-1114Acetic acid, lead salt, basic(乙酸，醋酸)51404-69-4115Lead oxide sulfate(硫酸盐)12036-76-9116Phthalato(2-)dioxotrilead69011-06-9117Dioxobis(stearato)trilead12578-12-0118Fatty acids, C16-18, lead salts(脂肪酸)91031-62-8119Lead cynamidate20837-86-9120Lead dinitrate(二硝酸盐)10099-74-8121Pentalead tetraoxide sulphate(四氧化盐)12065-90-6122Pyrochlore, anti