Document 8V8q4m5O8R79Z8mG8yB2zV4am

BFGoodrich The BFGoodrich Company Geon Vinyl Division 6100 Oak Tree Boulevard Cleveland, Ohio 44131 216-447-6000 i AO'S'Iii <--V- March 24, 1992 Dr. Gwen Ball Toxicological Services National Sanitation Foundation P.O. Box 1468 Ann Arbor, MI 48106 Dear Dr. Ball: I am enclosing the mfcr containing the Confidential Composition on Geon 87241-021. The Confidential Composition is being submitted for Servend International Incorporated. This formulation is Company Confidential and therefore subject to the generic Secrecy Agreement signed by BFGoodrich and the National Sanitation Foundation, October 24, 1979. If you have any questions, please give me a call (216/4477831). Sincerely, THE BFGOODRICH COMPANY GEON VINYL DIVISION Osy^LU *7! Connie N. Dillon Regulatory and Data System Specialist CND/jp cc: Joe Kelley 21538001 BFG14899 NSF InternationalMATERIAL FORMULATION CONFIDENTIAL REPORT Document Control Code FD02557-001 Company Number 41530 Standard Number 126 18 Regional Office 04 Issue Date 09/10/91 CBI Code ; Regional Representative RMC * * * DO NOT DUPLICATE*** I. PROGRAM PARTICIPANT SERVEND INTERNATIONAL INC. MR. GLENN FAUTZ 2100 FUTURE DRIVE SELLERSBURG, IN 47172 Plant At: SELLERSBURG, IN 47172 II. MODEL(S) Equipment Model Number(s) ALL Description of Equipment ICE OR ICE 6 BEVERAGE DISPENSERS AND ICE MAKERS III. PART(S) Description of Part(s) NA Part Number(s) NA Fabricated by SERVE! WM Surface Area of (sq. in.) Surface is [X]' Part is [X] Food "Zomif^Food Conta|||p Temperature (Range} SPalWy Exposelflij> 32 Type of Food/Water/ltc.l^iE/WATE __ ** "WStett IV. SUPPLIER Basic Material Surlier BE^^M)RI^MJ0RP0RATI0N Material Type j pvc^. . -w Complete Formulation Id GEON^^^^^^pl 5, v. composition! m FORMULATION ia^flERTINEN^i3ftTA.,,--..USl To Be Compl*l1fk By Basic Matrl^alL/Pigment " VI. CERTIFICATION 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, in the case of materials intended for food zone application the material meets the requirements of the Federal Food, Drug, and Cosmetic Act as amended. 21538002 Seal in the BLUE envelope provided, insert in an outer envelope and MAIL TO: Toxicology Services NSF International P0 Box 130140 Ann Arbor, MI 48113-0140 Page (1) BFG14900 21538003 PLEASE PROVIDE SlGNATURE/CERTIFICATION ON REVERSE SlOE. from .the. .St/oerrntondont of Oocumnnts. U. S. Government. Printing Office. Washington. O.C 20*02 (202-703*3236) or your iocl U.:6` Government Printino Office outlet. Title 2i (Pood end Orugs). Pams 1-99; Gonoral information and color add<tvos (di'CCt) (food nrt r>iu(ji). I'auj 170-159: OlrcCf and indited lood additives. Including n(jec1mnK to* use *' lood contact *:*v: materials. (?) bgv490V ''*'1 11::*' ?'1 FROM: p i 0 3 R 3 6 O BF GOODRICH COMPANY MESSAGE SERVICE TO: CLEVMAIN DOCUMENT: A ? A A1 5 4V LINES 16:05:55 03/09/92 ROUTE TO: DILL..ON, CONNIE N ##*#*##****#*****#*###*#**#*******##*##**#**#****#**#*****>******#***#*****#*# * GEON VINYL TECHNICAL DOCUMENT # ***#*********************#**:*******#*****#********#****#****************** Ri03360 GEON VINYL RECIPE 03/09/92 GEON 87241 NATURAL. 021 COMMODITY NO.: 87241 OoO SBC NBR: 13C5 LAB REP: BASED ON APPLICATION: U210 0 SHA WARNING LABEL. LOC: 12 DEPT: 5661 ISSUE. : EFFECTIVE DATE : 01 /01/92 DELETE FLAG : NO CM PR parts INGREDIENTS SE8 LOC PERCENT 78,43137 10.58823 2,35294 3.92156 1,56862 1,56862 1.56862 961 942 941 925 912 943 943 O0O452 710859 71070)0) 710356 0)0S086 001.016 00)1.0)34 1i(> X 37? BLENDEX 338 , 2301 X IJLTRAPFLEX H ' MARK 1900 MINERAL OIL USP CA STEARATE-FUSED i i0 210 220 305 310 510 520 12 78.431 10,588 2,353 3.922 1 ,569 1 .569 1 .569 1 0)0,,00)000 TOT AL. 1 00 * 0)00 SPECIFIC GRAVITY: TYPE SAMPLE: ISSUED: MARKETING APPROVAL: 1,33 HARDNESS: 0-81 COLOR: 2 BFG14902 R 0 U T Ei! I 0 : 1) 11...!... 0 N , C 0 N NI E N * * -ft-ft * * ft ft- ft- ft * ft ft ft * ft ft * ft ft ft ft * * * ft ft ft * ft * ft : ft ft * ftftftft * * : ft ft * ft * * ft ft ft ft ft -ft ft ft -ft ft- ft; ft ft: ft ft; -ft ft- ft- ft; ft- ft: ft- ft GFON VINYL TECHNICAL DOCUMENT ft ft ft; ft: ft ft ft: ft ft- ft: ft ft ft: ft ft: ft ft ft: ft- ft ft ft: -ft ft; ft: ft: ft: ft: ft: ft -ft; ft- ft: ft; ft; : ft: ft- ft: ft; ft ft!- ft- ft: ft ft: ft ft ft!- : ft; ft!- ft ft; ft; ft; ft ft; -ft; ft- ft ft; ft: ft; ft; ft ft; ft- -ft ft': -ft ft ft ft ft; ft: ft- El 03360 0 N V j: N L EECIPE U3/09/92 16:05 GEON 87241 NATURAL 021 COMMODITY NO,: 87241 O0O 021O LOC: 12 DEPT: 5*6? ISSUE: S92 EFFECTIVE DATE: 01/01/92 =======; PROCESSING INSTRUCTIONS Du NO! EXIST FOR RECIPE 21538006 BFG14903 ........... -'-.r ,jr-- .