CSA International in Europe - Product Areas - Plumbing Products

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Application for Drinking Water Products Evaluation

1.	Type of Product:
2.	Company Name:
	Address:
	Telephone No.:
	Fax No.:
	E-mail:	*
	Contact Name:
	Hours of Operation:
3.	Plant Facility:	(Fill out a separate application for each facility.)
	Address:
	Telephone No.:
	Fax No.:
	E-mail:
	Contact Name:
	Hours of Operation:
4.	Standard Required:
	Section:
	Date Published:

5. Please describe the equipment/products to be Certified:

6.a) For products certified by organizations other than CSA International, please indicate certification organization:

b) Is the full test data available to submit to CSA International for review?
yes no

7. Once this Form has been submitted, a certification specialist will contact you to help you complete the PMI form. If you prefer to send a printed copy of this Form to CSA International, our Mailing Address and Fax Number are:

CSA International
Attn : DWPEP/Plumbing
178 Rexdale Blvd.
Toronto, ON., M9W 1R3

Fax: (416) 747-4149
Telephone: 1-800-463-6727
E-mail:
dwpep@csa-international.org

8. I agree to provide CSA International with all pertinent documentation required to accurately access the Product for certification. I understand that in order for my products to become CSA certified and bear the CSA Mark, in the manufacturing of the product during and after the certification process.

Purpose of Collection: The information collected in this online form will be used for the purpose of gathering the necessary information to evaluate your Certification and Testing application.

Disclosure: This information will not be released to any third party except as required by law.

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