TROUBLE SHOOTING

4Badjuster is probably at one extreme end of the travel. Unscrew the skewer cap assembly and remove the skewer to see ifthe The
he adjuster knob is locked and will not turnI

,

adjuster is at the extreme firm or soft end of its travel. The spool will almost be off of the two dowel pins at the extreme firm setting Unlock the knob by rotating it clockwise, ifat the exteme soft setting, or counter clockwise, ifat the exteme firm setting.
Fork seems to “top out” or has a slighi ;cCunking feel when front wheel comes off the ground:

Excessive preload will result in a “top out” if the adjuster is at the extreme firm setting. Selecting elastomers with that better fit your weight and riding style and having the adjuster set mid range will eliminate “top out”. Also if you have converted your fork to Iong travel and removed both top out elastomers then the fork will clunk at the top. Diassemble per instructions and put one top out elastomer back in. , .I/ ,‘.
I, It is difficult to &art the skever cap be&se of ex&ssive elastomer preload:

~ sIf the preload adjuster is at the max preload and you are using firm elastomers it may be difi5cu.hto start the adjuster cap threads. I’ 2 . Rotate the adjuster knob counter clockwiSeto reduce preload., If you converted your fork to long travel by adding the l/2” Iong traveI elastomer but did not remove one of the topping elastomers there will be excessive preload. Disassemble the fork per instructions and remove one of the top out elastomers.I’ . :: L II :
The fork feels less active and is not &in& thi travel it used to when it was new:.

. ] Chances are that the fork is developing s&ion. Greasing the skewer so the elastomers slide easily will heIp, Complete dis&embIy* _ cleaning, and regreasing is also recommended periodically especially after mud rides. This will keep the fork in good shape and ,. :_: , working like new. .,
j

‘. Outer legs feel loose on inner le& and bishings, a knock or rock can be fert when push?dfiom

side to s&&z:

Either the lower bushing is missing or wore out. Disassemble per instructions, check both the upper and lower bushings fbr damage and replace if necessary. Clean, grease, and reassemble. ; .. ..
COMPUTER INSTALLATION INSTRUCTIONS

-

‘Follow the instructions in.I.your owners manual with the following FIGURE 12’ I . -, * exceptionsi I 1. Remove the front wheel and locate the receiver on the top of the right dropolit. 2. Use the template’to locate any holes drilled in the dropout in the . acceptable region. 3. Use a center punch’or nail to punch mark the location of the hole in
.. . the right dropout. 4. Drill l/8” dia. hole through&e dropout.

‘CYCLE CiMPUTER

MUUfUTLNC

b ,

5. Attach the receiver to the dropout by passing a zip tie through the hole and the receiver and tighten it securely (see sketch). 6. Attach the wire to the wheel side of the fork leg using zip ties or a strip of electrician’stape. Wind the wire arotmd the brake arch and then the front brake cable casing on. its path up to the handlebar mount. Do not attach the wire to the bicycle frame or any other part that ‘does not turn with ,‘the handlebar and fork , Doing so will reduce the life s@i of the wire : ” I. ,‘;‘II’ .,

.

DRILL

TEMPLATE

. REGION

‘.

PTdBLE

.1 ,

‘.

.

,’ ‘. ,, .‘L :,<;,’ _ ” ., ‘: ‘. -7

:. :.:

t

_.

.

.

..

ISE STANDSFOR
INDU~IAL STREI~GTH

EYEWEAR.
INNOVATIVE. AT ANSWER

IT’SNEW.
AND

I-r’s
WE

PRODUCTS

ARE PROUD TO OFFER ITBECAUSE NOT ONLY ARE 83-1027 Sr.aK/MRM BtUE THESE GLASSES SCRONG ENOUGH HtiW TO WlTHSTAND SFORTS a m BE You NEEu MADE BY

THEY’RE CU%OM Tubmum EVERYMING

ISE FRAMES ARE
FLOATlNG WIRE LNSIDE CR-

TITANIUM

EPDM
PLAmc

POLYPROPYLENE - WHICH ClVEs AND GREAT

THEM LIGHT WEIGH-I-, REXIBIUN !iTrRENm THEYCoMEINFIVE coL0Rs,-rw0WVER PATI-ERNS AND FOUR -

LENSSHAPES. MOUNT
YOUR CHOICE OF ONE w SEVEN DIFFERENTCOLOR

LENSES. AND AS YOU
CHANGE YOUCAN YOUR A-. REMOUNTA LENS

DIFFERENT WLOR THAT BEATER COMPLEMENTSYOUR ACXIONS

h% THIS

VERSATILITY THAT FIKST AmCTEDUSTO SUNGLASSES

ISE
AND IT%

THIS FEATURE THAT WE THINK YOU’LL FIND Mm BENEFICIAL twOOK FOR A PAlEL

FhMEKIl?Z 83-2000 BLAQ: DINKS 83-2001 GFGYGRGGVER 83-2002 YELLGW Gicxnr~~ 83-2003 WiimzDwws LENSKIT 83-2050 BLUE SPARK Sp~~~sra 83-205 1 AGENT 88 AARc 83-205L PI*&GREEN MEGA 83-2055 .&ID STEn -

INDUSTRIAL.

STRENGTH
83.1031 CcnmBLINI)IMKX
_- _----. __ ._ .-o-

. s m
\ ::.:. .

.

-

-: s .

2q7

.

_.

-

__--.

_

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_-.

“------^----_~__

._..

_I

_

-^_

I-

.-_l

--l._.-.-_

---.---_l_-_---

---.

-

-

15g. What plans does your firm have regarding . notification to dealers and consumers. Answer Products will: a. b. c. d:

corrective

action and / or
. -

Notify all consumers of the product defect per the guidelines and means deemed most appropriate by the Consumer Produet Safety Commission. Distribute a detail,ed inspection plan for authorized Mar&on deaIers, notice enclosed Request that the consumer take their Manitou 2 fork into one the many worldwide authorized deaIers to be inspected for cracks. Replace cracked crowns. Answer will cover all costs associated with the replacement.

RECALL EFFECTWENESS
AT-TN: Recall. Coordinator

CHECK -SUMMARY

5. HOURSEXPENDED
/ /

I

TRAVEL

j. TYPE OF FOLLOk’.‘-UP: 3. FIRM INSPECTED: NameAddress

ON-SITE

~ELCPH~NE /

7. DATE 9.

INSPECTED

F/r\

IN fTf ATING I THE RECALL:

Address

0. PRODUCT

REC Wholesaler -‘uetailer cons u mer Other (Specify)

2. TYPE OF CONSIGNEE: 3. PERSON(S) INTERVIEWED:

Name & TitleName & Title -

1. WAS FIRM NOTIFIED OF RECALL? RECALL NOTlFlCATlON Yes METHOD & DATE OF NOTIFICATION No -Yes (Notice date) PRESENTED TO INVESTIGATOR ---No INSTRUCTIONS? , N/A No N/A 1’ No No Yes Date ~~16,, WAS SUB-RECALL INVOLVED? Yes Yes . .

. DID FIRM FOLLOW WAS PRODUCT

RECALL

TAKEN

OFF SALE?

+

(lf “Yes” disctm details/ met3anism under “REMARKS’)

1 7. WERE RECALL/REPURCHASE ACTION PLAN NOTIFICATION OF RECALLED OR’CORRECTIVE . SIGNS POSTED? PRODUCT: product N/A No Yes _ *

II 3. INtiENTORY 1 I a. initial

inventory

received of the recalled ,

b. Inventory c. Inventory

at time of notification at time of inspection

d. Number of returns 1!3. DISPOSITION -i,. NUMBER 201. INJURIES 21. REMARKS: OR COMPLAINTS: N/A OF RECALLED PRODUCT:

OF PRODUCTS

DISPOSED:

Yes (Report by separate memo)

I

.
. ENDORSEMENT: -

INVESTIGATOR

AND DATE

SUPERVISOR

AND DATE

RECALL

I

EFFECTIVENESS

CHECK -SUMMARY

Y

.--

-

--

1 3. MIS:

.

13. PERSON(S)

INTERVIEWED:

Name & Title Name & Title -

I

t

74. WAS FfRM NOTfFJED

OF RECALL? RECALL NOTlFiCATfON FOLLOW

‘.

Yes ME-I-HO0 & DATE OF NOTIFICATION No PRESENTED TO INVESTIGATOR .--Yes Wotice -No INSTRUCTIONSI? , -N/A No N/A ,c: No No Yes Date Yes

date)
Yes ~I

15. DID FIRM

RECALL

WAS PRODUCT

TAKEN

OFF SALE?

16. ‘J/AS SUB-RECALL

fi\rVOLVED?

.
17. WERE RECALL/REPURCHASE ACTION PLAN NOTIFICATION OF RECALLED OR-CORRECTX’E SIGNS POSTED;? PRODUCT: -N/A No Yes

[if “Yes” discuss detar’/s/ mecharrism under “*REMARKS”)

_-

-

18. INVENTORY a. Initial i I *

’ inventory received of the recalled product I I * b. Inventory c. Inventory at time of notification at time of inspection

.

-

d. Number of returns 19. DISPOSITION NUMBER OF RECALLED PRODUCT: I

OF PRODUCTS

DISPOSED:

20. INJURIES ?I,, REMARKS:

OR COMPLAINTS:

N/A --

None

-

Yes (Report by separate memo)

-.

. . ..

--_

SUPERVLSOR

-1’

AND DATE

RECALL

EFFkTIVENESS

CHECK -SUMMARY --_

3. MIS: IT&RI . /-‘-‘wH/ ’ I 1 5. HOURSEXPENDED 7. OATEINSPECTED 9. FIRM INITIATING I RECALLED: Wholesaler Name & Title Name & Title 14. WAS FIRM NOTIFIED OF RECALL? RECALL 15. DID FIRM NOTIFICATION FOLLOW g,,; \/Retailer Fw&l: THE RECALL: HAZARD: Consumer ,z-/-,& , Other (Specify) TRAVEL

ON-SITE ?Q@PHONE

I
I

8. FIRM INSPECTED:

NameAddress

10. PRODUCT

12. TYPE OF CONSIGNEE: 13. PERSON(S) lflTERVlEWE0:

Yes METHOD & DATE OF NOTIFICATION No -Yes Wotice PRESENTED TO INVESTIGATOR -No INSTRUCTIONS;? . s N/A No .N/A !s’ / No No Yes .Date Yes

&te)Yes .

RECALL

WAS PRODUCT

TAKEN

OFF SALE?

6. WAS SUB-RECALL

INVOLVED?

(If “Yes”

discus

cfemi’ls/

.
7. WERE RECALL/REPURCHASE ACTION PLAN NOTIFICATION OF RECALLED

mechanism under 33 EMA RKYJ
.

OR’CORRECTIVE SIGNS POSTED? PRODUCT: . . . * -N/A No Yes s *

18. lNVENTOf?Y a. Initial I’ I I

inventory

received of the recalled product a

b. Inventory c. Inventory d. Number

at time of notification at time of inspection of returns OF RECALLED PRODUCT:

7s’. DISPOSITION NUMBER 20,s INJURIES 11. REMARKS:

OF PROOUCTS

DISPOSED: N/A None ,

OR COMPLAINTS:

_ Yes (Report by separate memo) ..

. ..

INVESTIGATOR

AND DATE

SUPERVISOR AN0 DATE

RECAL’L EFFECTIVENESS

C)?ECK -SUMMARY

5. HOURS EXPENDED

INSPECTED:

INfTlATfNG

Add

RECALL

NOTIFICATION

PRESENTED

TO INVESTIGATOR , -N/A Nd N/A \/ * No No Yes kite I Yes

15. DID FIRM FOLLOW WAS PRODUCT

RECALL

INSTRUCTIONS?

TAKEN

OFF SALE?

i
16. WAS SUB-RECALL INVOLVED?
+ -

Yes

.
17, WERE RECALL/REPURCHASE ACTION PLAN NOTIFICATION OF RECALLED

(If “Yes” discuss d&ifs/ mechanign under “R EMA RKm

OR’CORRECTIVE SIGNS POSTED? PRODUCT: product N/A No Yes N

;I 8. .I )
,I ’ I

INVENTORY

a. Initial

inventory

received of the recalled ’

b. Inventory

at time of notification. at time pf inspection

c. Inventory

d. Number of returns’ 19. DISPOSlTION NUMBER OF RECALLED PRODUCT:

OF PROOljCTS

DISP&ED: ’ N/A --None -

20.

INJURIES

OR COMPLAINTS:

Yes (Report by separate memo)

-.

21. REMARKS:

.
ENDORSEMENT:

fNVESTlGATOR

AND OATE

-

.

SUPERVISOR

AND DATE

RECALL

EFFECTIVENESS

CHECK -SUMMARY

5. HOURS EXPENDED

8. FIRM INSPECTED:

NameAddress

IO. PRODUCT

RECALLED: I Wholesaler Name & Title Retailer

11. HAZARD: Consumer Other (SpecifG)-

;

12. TYPE OF CONSIGNEE: 13. PERSON(S) INTERVIEWED:

i

-.

‘14. WAS FIRM NOTIFIED . OF RECALL? RECALL NOTIFICATION FOLL0.W

No PRESENTED

Yes

METHOD

& DATE OF NOTlFfCATlON -No No N/A No -

TO INVEST!GATOR , -N/A

-Yes
No Yes

(Notice date)
Oate Yes

l!5. DID FIRM
-

RECALL

INSTRUCTIONS?

WAS PRQOUCT

TAKEN

OFF SALE?

16. WAS SUB-RECALL 1

IN-VOLVED?

.

Yes

. I I ‘7. WERE RECALL/REPURCHASE
ACTION PLAN NOTIFICATION OF RECALLED

(/f “Yes” discuss detail%/ mechanism under “REMA RKCq

OR CORRECTIVE SIGNS POSTED? PRODUCT: . N/A -No Yes

1;,. INVENTORY
a. Initial

.

s

inventory

received of the recalled product-

b. Inventory

at time of notification at time of inspection of returns OF RECALLED PRODUCT:

~

1 c. Inventory d. Number

19. OISPOSITION NUMBER 20. INJURIES

OF PRODUCTS

DISPOSED: N/A . None

OR COMPLAINTS: .

Yes (Report by separate memo)

..

2l<, REMARKS:

!2. !3. ENDORSEMENT:

INVESTIGATOR

AND OATE

0
SUPERVISOR
‘SC Form 307 (81801

AN0

DATE

P

.

RECALL

EFFECTIVENESS

CHECK -SUMMARY

5. HOURS EXPENDED

$3. FIRM INSPECTEDi

Name Address

IO. PRODUCT

RECALLED: Wholesaler Name & Title Name & Title *Retailer

11. HAZARD: Consumer Other (Specify)-

2. TYPE OF CONSIGNEE: 3. PERSON(S) INTERVIEWED:

4. WAS FIRM NOTIFIED OF RECALL? RECALL NOTIFICATION

Yes METHOD & DATE OF NOTIFICATION . NO.--Yes (Notice da*) -No PRESENTED TO INVESTIGATOR \ -No. N/A N/A . -No No Yes Date Yes

5. DID FIRM FOLLOW RECALL INSTRUCTIONS? WAS PROOUCT TAKEN OFF SALE? j. WAS SUB-RECALL INVOLVED?

Yes

.
‘. WERE RECALL/REPURCHASE ACTION PLAN NOTIFICATION OF RECALLED

(N “Yes”discuss detai/s/ mechanism under “REMARKS”)

mOR CORRECTIVE SIGNS POSTED? PRODUCT: . N/A -No Yes

. INVENTORY a: Initial

inventory

received of the recalled product.

b. Inventory c. Inventory d. Number

at time of notification at time of inspection of returns OF RECALLED PRODUCT:

i;I. ‘OISPOSITION NUMBER 20. 21, INJURIES REMARKS:

OF PROOUCTS

DISPOSED: N/A None

OR COMPLAINTS: ’

Yes (Report by separatememo)

-*

22
!3. ENDORSEMENT:

INVESTIGATOR

AN0

DATE

SUPERVfSOR AND DATE

RECALL

EFFECTIVENESS

CHECK -SUMMARY

5. HOURS EXPEN

3. FIRM INSPECTED:

NameAddress

1~ 0. PRODUCT 1

RECALLED: Wholesaler Name & TitleName & Title METHOD Retailer

11. HAZARD: I Consumer Other (Specify)-

l1 2. TYPE OF CONSIGNEE:

i 3. .4. 1t -. -I

PEjlSON(S)

INTERVIEWED:

WAS FIRM NOTIFIED OF RECALL? ,RECALL NOTIFICATION No PRESENTED Yes & DATE OF NOTlFiCATION No -.Yes N/A No N/A No No Yes TO INVESTIGATOR \

Wotke date)- Yes Date Yes

15. DID FIRM FOLLOW RECALL INSTRUCTIONS? WAS PRODUCT TAKEN OFF SALE? INVOLVED?

16. WAS SUB-RECALL 1

(if “Yes” discuss details/ mechanism under “R EMA aKn

. 7. 'I
8. 1

WERE RECALL/REPURCHASE ACTION PLAN NOTIFICATION OF RECALLED OR CORRECTIVE SIGNS POSTED? PRODUCT: . a. Initial inventory received of the recalled product b. Inventory at time of notification N/A -NoYes

INVENTORY

.

c. Inventory at time of inspection d. Number of returns 3. DISPOSITION NUMBER 20. INJURIES OF RECALLED PRODUCT: OF PRODUCTS DISPOSED: N/A None

OR COMPLAINTS:

Yes (Report by separate memo)

-

2’1. REMARKS:

22. 23. ENDORSEMENT: ’

INVESTIGATOR

AND DATE

SUPERVISOR
Yi C Form 307 (8/801

AND DATE

RECALL
AT-TN: Recall Coordinator

EFFECTIVENESS
2m

CHECK

-SUMMARY 0 Rp/ p&y 1L F

3. MIS:
5. HOURS EXPENDED 3. TYPE OF FOLLOW-UP: 3. FIRM INSPECTED: NameAddress -ON-SITE r MELCEPH~NE / / 7. DATE INSPECTED 9. FIRM IN ITf ATI NG Name Address -TRAVEL

THE RECALL:
0. PRODUCT RECALLED: Wholesaler Name & TitleName & Title . la4. WAS FIRM NOTIFIED OF RECALL? RECALL NOTIFICATION Retailer 11. HAZARD: Consumer Other (Specify)-

2. TYPE OF CONSIGNEE: 1 3. PERSON(S) INTERVIEWED:

~.

Yes METHOD & DATE OF NOTIFICATION No PRESENTED TO INVESTIGATOR Yes Wotice -No I -N/A No No Yes Date

date) Yes

-If 5. DID FIRM FOLLOW RECALL INSTRUCTIONS? WAS PRODUCT TAKEN OFF SALE? 16. WAS SUB-RECALL 1 .

INVOLVED?

,

N/A

No -

Yes

(lf “Yes” discuss details/ mechanism under “REM4 RKS’7

-

‘I 7. WERE RECALL/REPURCHASE ACTION PLAN NOTIFICATION C. -8. INVENTORY a. Initial OF RECALLED

OR CORRECTIVE SIGNS POSTED? PRODUCT: N/A -No Yes

'1

.
inventory received of the recalled productb. Inventory c. Inventory d. Number at time of notification at time of inspection of returns OF RECALLED PRODUCT:

.

1 9. DISPOSITION NUMBER 2 Il. INJURIES 2

OF PRODUCTS

DISPOSED: . N/A None

OR COMPLAINTS:

Yes (Report by separate memo)

22, 23,, ENDORSEMENT:

INVESTIGATOR

AND DATE

RECALL
ATTN:

EFFECTIVENESS

CHECK -SUMMARY

Recall Coordinator 3. MIS: ’ 5. HOURS EXPENDED 7. DATE INSPECTED 9. FIRM INlTlATlNG Name Address TRAVEL

3.

TYPE

OF FOLLOW-UP: NameAddress

ON-SITE MEL~PHONE /

/

3. FIRM INSPECTED:

THE RECALL:
0. PRODUCT RECALLED: Wholesaler Name & Title Name & Title 4. WAS FIRM NOTIFIED Yes METHOD & DATE OF NOTlFiCATlON OF RECALL? -NoNo Yes (Notice date) RECALL NOTIFICATION PRESENTED TO INVESTIGATOR ,5. DID FIRM FOLLOW RECALL INSTRUCTIONS? s -N/A No N/A -’ OR CORRECTIVE SIGNS POSTED? PRODUCT: . . a. initial inventory received of the recalled product. b. Inventory c. Inventory d. Number at time of notification at time of inspection of returns OF RECALLED PRODUCT: -N/A No Yes . . INVENTORY OF RECALLED . . No No Yes Date Yes Retailer 11. HAZARD: Consumer Other (Specify)

2. TYPE OF CONSIGNEE: 3. PERSON(S) INTERVIEWED:

WAS PRODUCT

TAKEN

OFF SALE?

i. WAS SUB-RECALL .

INVOLVED?

Yes

(/f “Yes” discuss de&Is/ mechanikm under ‘REMARK.Y)

-

‘. WERE RECALL/REPURCHASE sACTION PLAN NOTIFICATION

1% DISPOSITION NUMBER 20. INJURIES

OF PRODUCTS

DISPOSED: N/A

21.

.

OR COMPLAINTS:

--

None

Yes (Report by separate memo)

->.

.

j

REMARKS:

:2. 3. ENDORSEMENT:

I

INVESTIGATOR

AND DATE

k SUPERVISOR
SC Fnrm ZW7 IR/Rn)

. 2,

r,

ANO DATE

1

RECALL

EFFECTWENESS

CHECK 1 S”MMARY

'1.TO:&+&
4.

ATTN:

R ew II Coordinator
I 7 .

FROM: 5. HOURS EXPENDED -p/n ,. TRAVEL ‘ /my

6. TYPE OF FOLLOW-UP: 8. FIRM INSPECTED: NameAddress

OrwinE WEL~PHONE

’ I

7. DATE INSPEOTED 9. FIRM INITIATfNG THE RECALL: Address

IO. PRODUCT

RECALLED: Wholesaler Name&Title Name & Title No PRESENTED Yes METHOD thetaher

7. HAZARD: Consumer Other E’@cifv)

TYPE OF CONSIGNEE: . 1 13. PERSON(S)
I’.

-7-l

INTERVIEWED:

14. WAS FIRM NOTJFIED OF RECALL? I RECALL NOTIFICATION & DATE OF NOTIFICATION NCi .--Yes N/A No N/A ,’ No -No Yes TO INVESTIGATOR ,

(Notice date) Date Yes

I

15. DID FIRM FOLLOW WAS PROOUCT

RECALL

INSTRUCTIONS?

TAKEN

OFF SALE?

16.’ WAS SUB-RECALL

INVOLVED?

Yes

(N “Yes” discus detaifs/ mechanism under “REMARKSIJ

17. WERE RECALL/REPURCHASE ACTION PLAN NOTIFICATION OF RECALLED

OR-CORRECTIVE SIGNS POSTED? PRODUCT: N/A ’ No : Yes

16. INVENTORY a. Initial

..
inventory received of the recalled product _ * b. Inventory c. Inventory at time of notification at time of inspection

d. Number of returns 19. DISPOSITION NUMBER 20. INJURfES 21. REMARKS: OF RECALLED PRODUCT: ..

OF PROOLJCTS DISPOSED: OR COMPLAINTS; N/A --None -

Yes (Report by separate memo)

-.

SUPERVISOR

ANO DATE

. . .:

,. 7-m

-*

. _. _. , ---

. .* d.

.

. . . . . . ..bZ

I-..

..._ . . ..m. .
I-.

e-p.-.-

-. .

.

.-. .

.‘.’ _ .

.a-.

- .:

.-

.=

-. -.--.

-

..

.- -..

;-

- .

. .-

. .-

)
-.-

.,:;*.

. .. _ .- * _. 1 _.
-.A

;‘.,-.

-- ._

;

. -

-I

._. ;.

.‘,

-

-.I

.

a

.
. . . .

PORT, 1A

RECEIVED BY:
TIME:-HAZARD PBIORLTY:

e

CORRECTIVE ACTIONS DIVISION REPORT SXEET: OFFICE USE ONLY

. lx.

ADDITIONAL PRODUCT ID~.XTIr'fCATION
A.

fdctntSfication/Scrrial ?Juxabet:

. $, 6
; .

, 2e

8. Location af Serial/Model2bnbers: 3. c. Certification on Froduct(ti, etc.): D, .
Average

tffetim& oL Ptoduct:

. '

Vafua: E. Unit Retail.

III.' ADDfTIdNAL DEFECT AND HAZXRD tNFORlUTfON
A.

Descriptionof defect:,

.

Dvfect Cont:izzued) Cause of Defect (for example. esiti, qyalL:y control., materials, production error):
.

c.

Date Discovered,Am

and W Whoit (name of person and

D.

tJhenvaze fifected Products Praduced (and how

deterafned): . -. . hnb~
P L.

Estimatw2 l?roporkfoaof Affected Products ED TotaL of Pruducts InvoLvad (and how decersimd) : Injury and Property Damage
(1) Xature

and sevmftp

of izjuq/ptoperty

dmage: tepartrd

- c2)

. @w Number and typo of Znjurfvs of fn&iwxts to dazei .%A&.

G,

TotaL Number of Products kvoLved:
. Nuder vith

Dfstrfbutots:

. H. Georgtaphical.

.I~.

MABUFACTUEtER/~ORTER
A.
8.

(if diff etent from "zepartinp Ffmxn)
/

Name:

*

.

pddresa: Telephaue Nudmr: Contact and TLtLe: ff aa I-lotted Pro&et, Product (if lyd . / Names of Other fmporters of . -

c. D. . Em

v,

D~S~~~BUT~WFR~~ATE

large company;
. ,
L

LABELER (US manufactuter unknown of if for example, Permep, Sears Gard)

A, B&

Add&s:

0, . E. DescrtptZon of InvoLve<f: m-

c

:

.

.

.

*

I.

VII. PRODUCT DOES NOT COMPLY WTTEI: C?SA ROLE OR STANDARD UNDER ~SFZUIED ACTS
A. Act

In.voLved:

8.
. 2.

Standard or Ban InvoLved: *

c*

Descriptfon of Noncomplfance:

Date Discovered and How:

NatffhatXon

to:

4

-

C 1 Dfstrfbutors

Date:
-

r 1 RetziLers

.

Date:. Method:
[ J Consunrers
Date:'

.

Method:
B,

RecaU. (and dato begun):

C.

RepUrChase,Re&nd, Repair (and date beszun): lhhnica.L lxx: Dispositionof Returned Units:
. .. . . * .

D.
E,

-

r+
c t:

\

.

Claimed for Fact atid&tent of ReportThis Confidentiality Lapse3 Wftlr Dotorminatfon Re Hztzard Data-Detailed

.

.

.

.

‘A

.
. . s , . ..:

. .

.

.

.

. .---: -. . . W..WC. ., a.-. v -0-e e-s-

m3 i