Application for Testing : Ceramicware QP15.App3/Issue 1

Application for Testing : Ceramicware QP15.App3/Issue 1
Customer Details
Company name:
Address:
VAT Number
Contact name:
Tel:
Post Code:
Fax:
Order Details
Your Order No:
Number of Samples:
Description:
Ref/Style No:
Date:
Colour:
End of Use:
Test Requirements:
(Please Tick As
Appropriate)
STORE GROUP:
1. Full Test to above standard
2. Lead and Cadmium Release
3. Dishwasher Compatibility
4. Microwave Compatibility
5. Thermal Shock Resistance
6. Others:
Standard
SPEC:
Special Instructions:
To be completed by the Laboratory :
(Vetting of the job to be completed after review of request-QP 15.1)
Entrance Number: _______________ Authorised Signature: _______________________
2113
Intertek - Labtest Portugal – Testes Laboratoriais, Lda.
Rua Antero de Quental, 221 Sala 102 – 4455-586 Perafita – Matosinhos
Tel.: (351) 22 999 80 80 – Fax: (351) 22 999 80 81