Document NG60XXnyD6R6pOgg5kJgJDXBE
FGoodrich
The BFGoodrich Company Geon Vinyl Division 6100 Oak Tree Boulevard Cleveland, Ohio 44131 216-447-6000
August 27, 1992
Chris Steele Drinking Water Additives Program NSF International (NSF) 3475 Plymouth Road P.0. Box 130140 Ann Arbor, Michigan 48113-0140 Dear Mr. Steele: I am enclosing a completed TDRS-A form for Geon 87431 Blue 440. The composition of Geon 87431 Blue 440 is confidential to BFGoodrich and therefore subject to the generic secrecy agreement signed by BFGoodrich and the National Sanitation International, October 24, 1979. Sincerely, THE BFGOODRICH COMPANY
Regulatory and Data System Specialist
0827--3/jp Enclosure
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NSF USE ONLY ( Document Control Code: Company No. 04500 Accepted By
] P/MI PL0G481
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TOXICOLOGY DATA REVIEW SUBMISSION -
NSF International
(NSF)
STANDARD 61: DRINKING WATER SYSTEM COMPONENTS
(CONFIDENTIAL INFORMATION)
FORM
A
FOR ASSISTANCE: 1-800-252-6010 From 9am to 4pm Eastern Time
TO 35 COMPLETED BY THE MANUFACTURER OF THE MATERIAL DESIGNATED BELOW. Please return form within 30 days or call for assistance.
I. IDENTIFICATION INFORMATION
Company name B. F. GOODRICH COMPANY (THE) Address 6 ICO OAK TREE BOULEVARD
CLEVELAND, OH
44131
Company contact: MR. JOSEPH C. KELLEY
Telephone Ftnbor ( 215' A47--6567__________
FAX Numbs*;,
( 2: 447-6245__________
Plant name Address
All plants (see attached)
Plant contact*?*..__________________________________________
________________________________________________________ TeXep&pp.e
_____________ ________FAX/
)
)______________________
If more than one plant location, append to this fotipa list <$$; each pi&nt location and plant contact.
1. Product name
GEON 87431 BLUE 440
Trade designation________________________________________________________________________________________________________________________________________________ If applicable, please specify other nai^i':m^ti?Mluch ySii^Sh to Certify this product
8
Category* and Function** codes for thi'Siijiproduct or material (see below) . a. Category Additigsliaal categories ff:**
b. Function Ackjiitiorwii|:-:functidofe?. 5 a
c. Other, please specify
____________________________________________________________
2. Virtually identical products orSpiterials (Attach justification).
Product name/Trade designation
Category(s)
Function(s)
3795002
Y"^t~fcj~iry ((Vrfp) ipes and Related Prodjcts (PnBj: tetectiye (Barrier) ifeterials, {EMUJ loaning ;iaiid Sealir^ . ftbtetiala (JASM) 'recess Media (EWO) far-jhanical EevioeS:: (MBCH)
Mechanical Plimbing. Devices (MZTO)
**Rjncticn (Code) Msorpticn (AES) Aeratim (AES) Bl^fVto-H/T.in^rH/DiatiiratjiS (ELD)
Chelaticn (KH.) Chemical Feeders (CHF) Disinfecticn Gmeratcxs (DEG)
Electrical Wires (ELW) Filtration (FLT)
*Fjx3hcn (Code) Fittings (FTT) Fluxes (FUO Gaskets/Sealing >faterials (GSK) Hcses/Tubing (EES) Ion Bodange (IXR) Joining ttaterials (JIG) Lubricants (LUB) (Tcidaticxi (CXI)
**Rmcticn (Cbde)
Daints/Cbatings (ENT)
Pipes (PIP)
Pimps (EMP)
.
Screens (SCR)
Iv
Switches and Sctisctts (SVG)
Valves and Related Fittings (VRF)
Water Treatment Devices (WID)
Well Casting (WCS)
Otter (OIH)
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II. FORMULATION INFORMATION
III. PRODUCTION AND CHEMICAL INFORMATION
1. Is the product x manufactured or__ mined?
a. If mined, is it purified? YES___ NO____ If YES, how?___________________________ _ Is it ground or mixed to a homogeneous mixture? YES___ NO___.
b. If manufactured or synthesized, provide the following: Please provide separate attachments as necessary. Manufactured: 1. Process description ilade on a bosh extruder or CM line (continuous mixture) 2. Literature and/or patent reference for the process______________________________ 4.........
Synthesized: 1. Recognized name of synthesis:______________________ 2. Literature and/or patent reference for synthesis method:.
3. Purification procedure___________________________________ _______________________ _ 4. Provide the analytical procedure for the analysis of your product. Provide either a literature reference
or a written procedureo 5. Molecular weight (molecular weight distribution for polymers)____ _____________________________________ 6. Itemize the reaction products of initiators, stabilizers, and catalysts used in the manufacture or synthesis of
your product.
c. Product is shipped in bulk containers. Product is handled/packaged by a single use (dedicated) system. Product is handled/packaged by a multiple use (non-dedicated) system.
If multiple products are handled, snow other products handled by the system:
2. Are any recycled or reprocessed materials used in thiSiproduct?____ YES____ NO. If yes, provide a separate attachment describing how '.maunties and lot-to-.ot variations are controlled.
3. Itemize below, known or suspected impurities in the product including, but not limited to, unreacted starting matenals, by-productSi tow molecular weight polymers, etc. If available, provide literature reference(s) or written procedure(s) for the identification of impunttls in your product and starting materials.
...................... Chemical Name____________
CAS#
____Analytical Method
3
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cav/at/1 uk5*A.PM3
IV. MIGRATION/EXTRACTION INFORMATION (Standard 61 Products)
1. Has the water solubility of the product been determined? ___ YES X NO
If yes, what is the solubility?@_____________
Temperature andpH
2. Have tests been run on your product to examine migration/extraction of a MATERIAL(s) or IMPURITY(s) from
your product into water?
YES ___ NO
If the answer is yes, please append the complete reports) for every component or impurity studied, Including a copy of the analytical method or a literature reference to the method.
3. 1C the product, for which the application is submitted, is a tank, pipe, fitting, device, or other similar product, and JE the water contact surface is coated or sealed, then provide the following information:
a. Indicate the coating or sealant and the method of application. Attach application, curing and use
instructions.
ys- Y:;:
b. Indicate the anticipated service life of the coating or sealant (e.g., 6 months. 5 years, etc.) and the testing procedures used to determine the life.................................................... Il;k_L
c. Attach information, data, and/or reports indicating anticipated permeability/leaching characteristics of the coating or sealant. If any coating or sealant is currently Certified by NSF under Standard 61, indicate which
one(s).
V. HEALTH EFFECTS
Analysis of the Applicant's product will be conducted to identify potential contaminants to the drinking water. Laboratory values of contaminant concentrations will be normalized to *aMhe-tap" values. Those contaminants for which the Environmental Protection Agency has not established a Maximum:Contaminant Level (MCL) may require additional toxicity testing according to the guidelines of NSF Standards 60/61. Appendix A. information you provide (as attachments to this form) regarding your knowledge of specific toxicology studies will expedite the applicant's Certification and may alleviate the need for additional toxicity testing/
1. Toxicology Studies: As an attachment to this form, ptease provide a detailed list of all known nutjliaJjfldflQd .
unpublished toxicology studies (acute, subchronic, chronic, mutagenicity, teratogenicity, reproductive,
carcinogenicity, epidemiology, etc.) relevant to your product, materials, ingredients, and/or impurities. For each
reference include:
-> /. >.
a. Name of specific material, ingredient, or impurity addressed by the study.
b. Type of study (Ames, Sister Chromatid Exchange, etc.).
c. Complete reference: (authorjsj, title, source, volume, pages, year).
d. Summary of study results (include a|: treatment-related effects; provide your opinion , with justification, for
any results you: feel should be discounted; attach complete reports, if desired).
___ (Check if no knowledge of toxicity data exists within your company related to this Listing application.)
2. A toxicology literature search provided by your company may expedite the toxicology review and minimize costs to the applicant forobtaining toxicology data. For each literature search appended to this form, itemize as described below: ' sS:;:,,.
Database File#
Keywords Date
.__________________ ______________
____________________ ______________________
______________________ ______________________ ______________________ ______________________
______________________ ______________________ ______________________ __ _
2373500'
(Check if no literature search has been, or will be, conducted by your company.)
BFG27260
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3. If any product, material, ingredient, and/or impurity contributed to tne drinking water as a result of your product should, in your opinion, either be exempt from toxicology evaluation (e.g., non-migratory, no residual, etc.) or should
be evaluated in light of previous regulatory clearance (e.g., 21 CFR, EPA National Primary L..fixing Water Regulations, etc.), please complete below:
Product, material, ingredient. or impurity
Complete Reference
Justification (provide documentation) or opinion
VI. ATTACHMENTS AND SIGNATURE List Attachments to this form___________
No. of pages.
I hereby certify that the information provided is accurate and complete, and that I, and the Company I represent, know of no reason the product/material described herein shouid not be used in contact with drinking water.
Signature Typed or printed name
j 71 .
jU
:|:!S. Conii:ie::5 Jl. IKLlOn
Date 8/28/92
Position/Title Corr.Danv Phone 216/447-7831*!ill?*
Regulatory and Data System Specialist The ISPGood rl ch Company
Telex
FAX 216/447-6459__________
The following authorization Is OPTIONAL. It in no way authorizes NSF to share the information with other Applicants. Authorized NSF staff ONLY will be allowed access to this information. By completing this authorization, this Form A may be used fo support the referenced ingredient/material/product as part of another applicant's package.
I give NSF permission to use the information contained in this TDRS Form A as a basis for reviewing/accepting other products which use this specific ingredient/material/product covered by this application.
I Optional Authorization____________________ _____________
WHERE TO MAIL? Insen the completed form in an envelope marked "CONFIDENTIAL BUSINESS INFORMATION,- seal in an outer envelope, and ratum to:
VIA U.S. MAIL:
Additives Tpxiealogy Group NSF International (NSF)
PO Box 130140 Ann Arbor. Ml 48113-0140
VIA COURIER SERVICE: Additives Toxicology Group NSF International (NSF) 3475 Plymouth Road Ann Arbor, Ml 43105
l Copyright 1991 NSF All Rights Reserved
cav/i:/rERS-A.PMS
BFG27261
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Plant Locations:
Avon Lake
Moore and Walker Roads
P.0. Box 134
Avon Lake, OH 44012
Tele: 216/933-0100
Fax:
216/933-0231
Calvert City
Hwy. 1523 Industrial Loop
P.O. Box 527
Calvert City, KY 42029
Tele: 502/395-4151
Fax:
502/395-3267
Deer Park
Tidal Road
P.O. Box 900
Deer Park, TX 77536
Tele: 713/930-9400
Fax:
713/930-9465
Henry
Route 1
P.O. Box 15
Henry, IL 61537
Tele: 309/364-2311
Fax:
309/364-9447
LaPorte 2400 Miller Cutoff Road LaPorte, TX 77571 Tele: 713/476-8000 Fax: 713/476-8009
Long Beach
2104 E. 223rd St.
Carson, CA 90745*
Mailing Address:
P.O. Box 9077
Long Beach, CA 90810
Tele: 310/513-7100
Fax:
310/513-7125
Louisville
4200 Bells Lane
Louisville, KY 40211
Mailing Address:
P.O. Box 32950
Louisville, KY 40232
Tele: 502/772-5900
Fax:
502/772-5772
Pedricktown
Porcupine Rd & Rte 130
P.O. Box 400
Pedricktown, NJ 08067
Tele: 609/299-5400
Fax:
609/299-8431
Plaquemine
Rt. 988 River Road, N.
P.O. Box 578
Plaquemine, LA 70764
Tele: 504/387-3151
Fax:
504/687-6215
Terre Haute
3100 N. 35th Street
Terre Haute, IN 47804
Tele: 812/466-4204
Fax:
812/466-9200
BFG27262
13735007