Supplier's Declaration of Conformity

for Material Declaration Management

1) SDoC ID No.

2) Issuer's name:

Issuer's adress:

3) Object(s) of the 1)
declaration:
2)

3)

4)

5)

4) The object(s) of declaration described above is/are in conformity with the following documents:

5) Document No.: Title: Edition Date of issue:

6) Additional Information:

Signed for and on behalf of:

(Place of issue) Date of issue

7)
(Name, function) (Signature)
 Material Declaration
<Date of declaration>

Date

<MD ID Number> <Supplier (respondent) Information>

MD-ID-No. Company name

Division name

<Other information> Address

Remark 1 Contact person

Remark 2 Telephone number

Remark 3 Fax number

E-mail adress

SDoC ID No.

<Product Information>

Delivered Unit
Product Name Product Number Product Information
Amount Unit

<Material Information>

Unit

This material information shows the amount of hazardous materials contained in 1 (Unit : piece, kg, m, ㎡, ㎥, etc.) of the product.

Present above If yes,

Threshold*
Table Material Name the threshold value material mass If yes, information on where it is used
value
Yes or No Amount Unit

Asbestos Asbestos 0.1 %* No

PCB's Polychlorinated Biphenyls (PCBs) 50 mg/kg** No

Chlorofluorcarbons (CFC's) No

Table A** Halons No

(Materials Other fully Halogenated CFC's No

listed in Carbon Tetrachloride No

Ozone depleting no threshold
appendix 1 1,1,1-Trichloroethane No
substances value
of the Hydrochlorofluorcarbons No

Convention) Hydrobromofluorcarbons No

Methyl Bromide No

Bromochloromethane No

2,500 mg total
Anti-fouling systems containing organotin compounds as a biocide No
tin/kg

EU*** Perfluorooctane sulfonic acid (PFOS) 10 mg/kg No

Present above If yes,

Threshold*
Table Material Name the threshold value material mass If yes, information on where it is used
value
Yes or No Amount Unit

Cadmium & Cadmium Compounds 100 mg/kg No

Table B ** Hexavalent Chromium and Hexavalent Chromium Compounds 1,000 mg/kg No

(Materials Lead and Lead Compounds 1,000 mg/kg No

listed in Mercury and Mercury Compounds 1,000 mg/kg No

appendix 2 Polybromated Biphenyl (PBB's) 50 mg/kg No

of the Polybrominated Dephenyl Ethers (PBDE's) 1,000 mg/kg No

Convention) Polychloronaphtalenes (Cl>=3) 50 mg/kg No

no threshold
Radioactive substances No
value

Certain Shortchain Chlorinated Paraffins 1% No

EU*** Brominated flame retardants (HBCDD) 100 mg/Kg No

* Please refer to the IMO Guidelines Resolution MEPC.269(68) and EMSA's Best Practice Guidance on the Inventory of Hazardous Materials
** In accordance with Hong Kong International Convention for the Safe and Environmentally Sound Recycling of Ships, 2009
*** In accordance with Regulation EU No. 1257/2013 of the European Parliament and of the Council of 20 November 2013 on Ship Recycling and amending Regulation EC No. 1013/2006
and Directive 2009/16/EC