Document 5LYpJ1ZrKJakBVpVmmwwdqNb5

BFGoodrich The BFGoodrich Company 3925 Embassy Parkway Akron. Ohio 44313-1799 /?/ 6,00 idbdb-l^ January 23, 1990 Toxicological Services National Sanitation Foundation P.O. Box 1468 Ann Arbor, Michigan 48106 Dear Gentlereader: a L ^I am enclosing completed Material Formulation Confidential Reports for Geon 87321 White 124 and 8761 White 127 for Coleman Powermate, Inc.)) Kearney, NE. The composition of Geon 87321 White 124 and Geon 8761 White 127 are confidential to BFGoodrich and therefore subject to the generic secrecy agreement signed by BFGoodrich and the National Sanitation Foundation, October 24, 1979. Sincerely, 1 PANY W. C. Bachtel Toxicologist Health' and Environmental Services 00123-6/jp cc: J. C. Kelley - CL-OTM-3 BFG07383 20832001 * NATIONAL SANITATION FOUNDATION MATERIAL FORMULATION CONFIDENTIAL REPORT Document Control Code WT00696-001 Company Number 10260 Regional Office 02 Issue Date 09/27/89 Regional Representative JSA * * * DO NOT DUPLICATE Standard Number 58 CBI Code ___________ it it it I. PROGRAM PARTICIPANT COLEMAN POWERMATE, INC. MR. TOM VACHAL 125 AIRPORT ROAD KEARNEY, NE 68848 Plant At: KEARNEY, NE 68848 II. MODEL(S) Equipment Model Number(s) 0WP30-1000 Description of Equipment Reverse Osmosis System III. PART(S) Description of Part(s) Housing, Membrane Body Part Number(a) 0WP00-0004 Fabricated by Payne Manufacturing Co., IttC* Surface Area of Part(s) (sq. In.) 53.4 ,, ? Cbnt*<St Area (s^*' fiw) 43 * IV. SUPPLIER Basic Material Supplier Material Type Complete Formulation Id B F Goodrich ' PVC 1120 GEON 8761 white 12? [ ] Natural Precolored: [ ] See Eapm F V. COMPOSITION OF FORMULATION AND PERTINENT DATA - USB-REVERSE SIDE. To Be Completed By Basic Material/Pigment Supplier. VI. CERTIFICATION (Check One. Use alternate only fur non-FDA materials such as brass.) [ ) It is herein certified that thin material-i*. intended sfog! the specific end use application. It is further certified' that the information provided is accurate and complete, and that the material meets the requirements of the Federal Food, Drug, and Cosmetic Act as amended. f J It is herein certified that this material is intended for the specific end use application. It is further certified that the Information provided ia accurate and complete, and that I, and the company I represent, know of no reason this material should not be used in contact with drinking water. Company Signature . BASIC MATERIAL SUPPLIER &F .ci /> r h/lU) Title /v c'ftjvic * i Gen,fic-c Address UUt St/cfot'e' Telephone 1/U ' 6$ in FAX^ Date ______________________________ _________ Seal in the BLUE envelope provided, insert in an outer envelope and MAIL TO: Toxicological Services National Sanitation Foundation P.O. Box 1468 Ann Arbor, Ml 48106 Page (l) ^ 2083200; BFG07384 A V. COMPOSITION OF FORMULATION AND PERTINENT DATA Chemical Description of Ingredient (Do NOT Use 'Trade Names) Please verify the material type/color and formulation identification referenced in Section IV on the reverse. Parts by Weight Supplier Section of the U.S. Code of Federal Regulation's (21 CFR)* under which accepted. Geon 87^ White 127 Polyvinyl Chloride Styrene-Acxyonitrile Dirnethyl/Moncnethyltin Isooctylmecapto Acetate 100.0 2.0 1.3 BFGoodrich BFGoodrich Argus Prior Sanction 181.32 - . /v.f-;:. 178.2010 Titanium Dioxide Calcium Stearate 2.0 DuPont 177.2600 ' 2.0 Synthetic 178.2010 Products Mallinckrodt Norak Witoo N,N'Ethylene Bis Stearamide 2.0 Garstab 177.1210,(181.28 ' Hunko Interstab :; .............. PLEASE PROVIDE SIGNATURE/CERTIFICATION ON REVERSE SIDE. Available from the Superintendent of Documents, U. S. Government, Printing Office, Washington, D.C. 20402 (202-783-3238) or your local U. S. Government Printing Office outlet. Title 21 (Foodand Drugs), Parts 1-99: General..information and color additives, (direct). 21 (Food and Drugs), Parts 170-199: Direct and indirect food additives, including ingredients for use in food contact materials.- (2) 0832003 11 bFG07385 NATIONAL SANITATION FOUNDATION MATERIAL FORMULATION CONFIDENTIAL REPORT Document Control Code WT00697-001 Company Number 10260 Standard Number 5fl Regional Office 02 Issue Date 09/27/89 ~CBI Code Regional Representative JSA * * * DO NOT DUPLICATE * * * I. PROGRAM PARTICIPANT COLEMAN POWERMATE, INC MR. TOM VACHAL 125 AIRPORT ROAD KEARNEY, NE 68848 Plant At: KEARNEY, NE II. MODEL(S) Equipment Model Number(s) OWP30-1000 Description of Equipment Reverse Osmosis III. PART(S) Description of Part(s) Housing Membrane End Caps Part NumbetCa> OWP00-O005 ....... C* a L A a m ^ a jf.'.vllkM'K'/: :>:Ba in* a Vf P ^ m 68848 IV. SUPPLIER, , , Basic Material Supplier Material Type Complete Formulation Id B F Goodrich PVCJ^JI GEGWJ&7321 White U* [ ] NaCWfAsL W] Praddicted [ ] See Form J V. COMPOSITION OF FORMULATION AND PERTINENT DATA - USE: REVERSE SIDE To Be Completed BySasidMateriei/Pigment Supplier*^ CERTIFICATION (Check Ond**, Use alternate only for abn-FDA aut^erials such as br; [ ] It Is herein certified that tklintended JEo| the specific end use application. It is further certtifled-'that the information provided is accurate and complete, and that the material meets the requirements of the Federal Food, Drug, and Cosmetic Act as amended. [ ] It is herein certified that this material is intended for the specific end use application. It is further certified that the information provided is accurate and complete, and that I, and the company I represent, know of no reason this material should not be used in contact with drinking water. Company Signature, Title Address Telephone Date______ BASIC MATERIAL SUPPLIER 2/C - t/Vf- C - l FAX X/6 - t/Wl ~ 16 Q$~ ________________________________________ Seal in the BLUE envelope provided, insert in an outer envelope and MAIL TO: Toxicological Services National Sanitation Foundation P.0. Box 1468 Ann Arbor, MI 48106 Page (1) 20832004 BFG07386 <\ v. COMPOSITION OF FORMULATION AND PERTINENT DATA Chemical Description of Ingredient (Do NOT use. Trade Names) Please verify the material type/color and formulation identification referenced in Section IV on the reverse. Geon 87321 White 124 Parts by Weight Supplier Section of the U.S. Code of Federal Regulations (21 CFR)* under which accepted. Polyvinyl Chloride 100.00 BFGoodrich Prior Sanction Styrene-Acrylonitrile 3.00 BFGoodrich 181.32 Calcivm Carbonate 12.00 Pfizer 182.5191, 184.1191 Titaniun Dioxide 2.00 DuPont 177.2600, Calcium Stearate 1.5 Synthetic ,178.2010 Products Mallinckrodt Norak i||:: Witoo Mineral Oil, USP Butyl Tin Isothioglyoolate 2.0 Witco 1.5 jMST 178.3620 NSF Std 14 soozesos PLEASE PROVIDE SIGNATURE/CERTIFICATION ON REVERSE SIDE. * Available from the Superintendent of Documents, U. S. Government, Printing Office, Washington, D.C. 20402 (202-783-3238) or your local U. S. Government Printing Office outlet. ,, Title 21 (Food and Drugs), Parts 1-99: General information and color additives (direct). Ntoe 21 (Food and Drugs), Parts 170-199: Direct and indirect food additives, including ingredients for use in food contact materials. (2) BFG07387