大昶電腦配件(蘇州)有限公司
TA SUN Computer Accessory (Su Zhou) CO.,LTD
Certificate of Non-use for The Controlled Substances/不使用环境管理物质保证書
(For approval/承認用)
Date/日期: / / Vendor code/供應商編號: Company name/公司名稱: Responsible-person name/負責人姓名: E-mail/電子郵件:
(Company Stamp/公司章) (Responsible-person seal/負責人簽名或蓋章)
We hereby declare this “Product” that all substances of combinations classified
at level 1 (the management standard specified in 材料、零部环境关联物质管理程序， issued by TASUN) are not used for the following materials and substances [1] the materials used for parts to be sold to your company; [2] Packaging materials; and [3] other substances used in manufacturing processes. Regarding the above-mentioned materials and substances, we notify that they are composed of the ingredients given at the composition table or MSDS.
我們公司在此宣告此「產品」之所有組成物質，在第1級管理物質之分類中(大昶材料、零部環境關聯物質管理程式中所訂定之管理標準)皆沒有使用到下列之材料和物質：包含(1)出售至貴公司零件的材質；(2)包裝材料；以及(3)在所有生產過程中所使用到的其他物質。關於上述提及的材質與組成物質，我們將在成分表或MSDS中完整告知產品之所有組成成份。
Part name/零件品名: Part No/零件廠商料號: Customer P/N客户料號: Production plant/生產地點:
1. Heavy metals/重金屬
a. b. c. d. 2.
Cadmium and cadmium compounds/鎘以及鎘化合物 Lead and lead compounds/鉛以及鉛化合物 Mercury and mercury compounds/汞以及汞化合物 Hexavalent chromium compounds/六價鉻化合物 3.
4. 5. 6. 7. 8.
e. Nickel and Nickel compounds/鎳以及鎳化合物 Brominated organic compounds/有機溴化合物
a. Polybrominated biphenyls (PBB)/多溴聯苯
b. Polybrominated diphenylethers (PBDE)/多溴二苯醚 c. Other brominated organic compounds/其他有機溴化合物 Chlorinated organic compounds/有機氯化合物 a. Polychlorinated biphenyls (PCB)/多氯聯苯 b. Polychlorinated naphthalenes (PCN)/多氯化萘 c. Polychlorinated terphenyls (PCT)/聚氯三聯苯 d. Chlorinated paraffins (CP)/氯化烷烴
e. Other chlorinated organic compounds/其他有機氯化合物
Tributyl tin compound, Triphenyl tin compounds/三丁基錫化合物、三苯基錫化合物 Asbestos/石棉
Specific Azo compounds/特定偶氮化合物 Formaldehyde/甲醛
Polyvinyl chloride (PVC) and PVC blends/聚氯乙烯以及聚氯乙烯混合物
*If any required items cannot be written on this above sheet, write necessary items on the below remark/ 如有任何重要事項未能填寫在此上述表單，請書寫在註記欄位中。
Remarks/註記: