1E_reportform_2008

1E.08

Please TYPE or PRINT clearly

Laboratory: Lab Member ID:

Address: City: State: Zip Code: Country: Test Technician Performing Test: Report Submitted By: Email:

Specific Product Tested (Product description should include, as applicable, product name, brand, model number,

serial number and similar information. It is strongly recommended that photographs accompany this report .):

Date Tested:

Number of samples tested: Number of replicate tests performed: Gross Weight:

External Container Size (LxWxD): Test Number (if assigned by Laboratory ): Product Damage Tolerance (PDT): Package Degradation Allowance (PDA): Method used to determine pass/fail: PDT/PDA Determined By/Date:

Describe

entire shipping unit. Package description must be detailed and specific and should include type, style and material of packaging;

corrugated board composition; cushion details including performance; film gage and composition; application or package forming details; mold numbers; any pallet or skid; unitization method for unit loads; methods of closure, etc. It is strongly recommended that photographs, detailed drawings, and/or complete specifications of both exterior and interior packaging accompany the report. It is recommended that a picture or drawing of both exterior and interior packaging accompany this report.

C ERTIFIE

D L ABORATORY

M ETHOD U SED Vertical Linear (fixed displacement) Random

Describe restraining devices used, if any:

Fixed Displacement

List the face that rests on platform:

Minutes: @ Frequency (CPM/Hz): = Number of Impacts:

Inspection after fixed displacement Vibration? Yes No Results of inspection: Pass Fail

Random Vibration

List the face that rests on platform:

Check here to verify that you have used the required breakpoints listed below, testing for a total of 60 minutes :

Inspection after random Vibration? Yes No Results of inspection: Pass Fail

M ETHOD U SED Incline-Impact Horizontal Sled

Use the spaces below to record the heights or velocities and orientations of each shock:

Pass Fail

Comments or recommendations (include any alternative methods used and the reason used):

1E.08