Document EmDywJ5939EZ5Z4J1qXxNv04V

BFGoodrich The BFGoodrich Company 3925 Embassy Parkway Akron. Ohio 44313-1799 A/j </VdO June 15, 1989 Toxicological Services National Sanitation Foundation P.0. Box 1468 Ann Arbor, Michigan 48106 Dear Gentlereader: > / Y' Enclosed is a(^Material Formulation Confidential Report for BFGoodrich Geon 8761 Gray 273 submitted for Wilch Manufacturing Company . ) The composition of Geon 8761 Gray 273, is confidential to The BFGoodrich Company and therefore subject to the generic secrecy agreement signed by The National Sanitation Foundation and BFGoodrich, October 24, 1979. Sincerely, THE BFGOODRICH COMPANY W. C. Bachtel Toxicologist Health and Environmental Services 90615-3/jp cc: J. C. Kelley - CL-OTM-3 (w/o attachment) BFG18852 T000TTZ2 NATIONAL SANITATION FOUNDATION MATERIAL FORMULATION CONFIDENTIAL REPORT ^ Document Control Code FD00331-001 Company Number 50700 Regional Office 02 Issue Date 04/18/89 Regional Representative J. CHAPPELL * * * DO NOT DUPLICATE Standard Number 18 CBI Code *** I. PROGRAM PARTICIPANT WILCH MANUFACTURING COMPANY MR. DONALD ROGERS 1345 SW 42ND STREET TOPEKA, KS 66609 Plant At: TOPEKA, KS 66609 II. MODEL(S) Equipment Model Number(s) 25, 75, 1 275-GS ,-GC , -PC , - 1 1 2-SLG ,-COG ,-SLBIB ,-COP Description of Equipment SLUSH MACHINES III. PART(S) Description of Part(s) AUOTMATIC FILL RETAINER, FLOAT RETAINER, Part Number(s) Fabricated by HARVEL PRODUCTS Surface Area of Part(s) (sq. la.) Contact Area (a<| In.) 1.22 Surface is [X] Smooth Part is [X] Food Zone, Food Contact Temperature (Range) Part(s) Exposed to 20 TO 90 F Type of Food/Water/Etc. JUICE, ALCOHOL CARBURETOR IV. SUPPLIER. Basic Material Supplier Material Type Complete Formulation Id B.F. GOODRICH PVC ROD GEON 8761-273 [ ] Natural [ ] Precolored: C ] See Form V. COMPOSITION OF FORMULATION AND PERTINENT DATA - USE REVERSE SIDE. To Be Completed By Basic Material/Pigment Supplier. 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. Company__ Signature Title____ j Address__ Telephone Date BASIC MATERIAL SUPPLIER The EPGoodrich Company Toxicologist 3925 Qnbassy Parkway 216/374-3422 FAX June 15. 1989 216/374-233? 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) zomnzz BFG18853 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 Regulations (21 CFR)under which accepted. Polyvinyl Chloride Styrene-Acrylonitrile Copolymer Dibutyltin Bisisooctyl Thiglycolate Titanium Dioxide Carbon Black, Furnace Calciun Stearate Ethylene Bisstearamide 100.00 2.0 2.0 1.7 0.162 2.0 2.0 BFGoodrich Prior Sanction BFGoodrich 181.32 M&T Witoo NSF - Potable Water DuPont 177.2600 Cabot 177.2600 Synthetic Proc 178.205& Witoo LoraoJ Prior Sanction Mortom^hidko! fc'OOOTTZ3 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 Orugs), Parts 1-99: 21 (Food and Drugs), Parts 170-199: General information and color additives (direct). Direct and indirect food additives, including ingredients for use in food contact materials. BFG18854