SEI Certification Program Manual

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1 Safety Equipment Institute SEI Certification Program Manual Section 26: ANSI/ASTM/CSA/NIJ Protective Clothing/Equipment and Footwear Program

2 26.0 ANSI/ASTM/CSA/NIJ Protective Clothing/Equipment and Footwear Program Standards ANSI/ISEA Limited Use and Disposable Coveralls ASTM F Protective Footwear ANSI/ISEA High Visibility Safety Apparel CAN/CSA Z96-09 (R2014) High Visibility Safety Apparel CAN/CSA Z Protective Footwear NIJ Public Safety Bomb Suit Standard, NIJ Certification Program Requirements NIJ Criminal Justice Restraints 26.1 Certification Submittal Package A Certification Submittal Package shall include an SEI Certification Submittal form (see Section 26A: SEI Certification Submittal Form) and a Components & Materials Description Checklist form (see Section 26B: General Components & Materials Description Checklist) for each product model, variant or accessory being submitted. Completion of the submittal package serves four primary purposes: 1. The submittal package provides SEI and the SEI Quality Assurance Auditor with a description of new, modified or products to be selected for annual certification. 2. The information provided by the manufacturer in the submittal package confirms to SEI the product design and components. 3. Receipt of the submittal package by the testing laboratory, from SEI, serves as the laboratory s authorization to begin testing the product(s) and allows laboratory personnel to verify that the correct product samples have been received. 4. The return of a signed copy of the submittal form from the testing laboratory provides SEI with a record of the date testing was completed on the product model. Over the life of the product, subsequent submittal packages shall document that the product model submitted for certification testing is identical to samples previously tested, except where Class I model changes have been tested and documented through the submission of additional SEI submittal packages or documented Class II changes have been made. It is therefore necessary that each submittal to SEI include sufficient product description information, which is achieved by a complete components and materials listing to uniquely and unambiguously identify the product model in question (see Section 14: Product Changes). SEI Certification Submittal Form Each submittal must be identified on the submittal form as either (1) initial certification, (2) annual recertification, (3) Class I change, or (4) Class II change. Finished product manufacturing facilities 1 of 11

3 (assembly) located at a different address (i.e. suppliers or company-owned factories) shall be identified in Section 3 of the submittal form. The SEI Certification Submittal Form shall be signed by the authorized manufacturer representative within the participating company having the authority to authorize expenditures for testing. Components & Materials Description List The product description information may be (a) listed on the Component and Materials Description Checklist form, (b) provided as a separate listing by the manufacturer (i.e. Bill of Materials), or (c) appropriate engineering drawings/ specification sheets. Use of Section 26B: General Components and Materials Description Checklist form is recommended. The following information is to be included on each Components & Materials Description Checklist. Brief examples are provided for guidance. A. Description of Major Components All major components and materials shall be identified and described. Where possible, include brand name and part number, supplier name and location. B. Primary Materials Materials used in the construction of major components shall be identified. Identification shall include trade names, if applicable. All changes shall be reported to SEI for evaluation and possible action. C. Manufacturing Locations All locations in which the product model is manufactured or assembled must be identified on the SEI Certification Submittal Form. If major components are manufactured by another company and purchased by the SEI participants, the name and address of the manufacturing facility and contact name shall be identified on the Components & Materials Description Checklist. D. Specification Sheets or Technical Bills of Materials Product specification sheets or technical bills of materials (BOM) may be included with the SEI Certification Submittal Form in addition to the Components & Materials description checklist to fulfill some or all other requirements noted above. In the case of annual recertification, the appropriate documents (i.e., submittal form and components and materials listing or BOM) shall be prepared prior to the sample selection audit and available to the auditor during the audit for reference and confirmation of product. E. Confidentiality All product information received by SEI staff, the SEI Quality Assurance Auditor, or the SEI testing laboratory shall be considered confidential and shall not be released to any third party without written authorization to do so (with the exceptions noted Section 3: Manufacturer s Agreement for response to a subpoena, court order or other compulsory process). 2 of 11

4 26.2 Protective Clothing Program Codes SEI Reference Program Code DC PF HV Standard Description Product Type Standard Standard for Limited-Use and Disposable Coveralls Standard Specification for Performance Requirements for Protective (Safety) Toe Cap Footwear American National Standard for High-Visibility Safety Apparel and Headwear Standard on High-Visibility Apparel Limited Use and Disposable Coveralls Protective Footwear High Visibility Safety Apparel High Visibility Safety Apparel ANSI/ISEA 101 ASTM F2413 ANSI/ISEA 107 CAN/CSA Z96 PFC Standard on Protective Footwear Protective Footwear CAN/CSA Z195 BSS Standard on Public Safety Bomb Suit Public Safety Bomb Suit Standard NIJ , NIJ Criminal Justice Restraints Protective Restraints NIJ 1001 SEI utilizes SEI Reference Numbers internally to identify each SEI participant and their unique models and variants. The first set of two or three letters/numbers indicates which standard program code the model/variant is being certified against. The second set of three letters indicates the SEI participant's unique identification. The third set of numbers is assigned by SEI to identify each model (see definition below) being certified. eg: BBH ABC 03 eg: BBH ABC V03 Where BBH identifies the standard program code Where ABC identifies the unique participant identification Where 03 identifies the model submitted for certification Where V03 identifies the model as the third variant (V03) for this Participant Identification (ABC) 3 of 11

5 26.3 Definition of a Model Model is the collective term used to identify a group of protective devices of the same basic design and components from a single applicant produced by the same manufacturing and quality assurance procedures that are covered by the same certification. Any characteristic that affects the device s performance under the limits of the current certification standards constitutes a different model. For purposes of the SEI Certification Program, the above definition of the term model uses performance characteristics as the basic criteria Application & Annual Certification Fees Testing shall be performed annually. When an initial submittal package is submitted to SEI, the Application Fees and Annual Participation Fees (See Section 7: Annual Participation Fees) are due. Upon completion of initial testing, Annual Model Certification Fees are due. The following is a schedule of application fees and annual model certification fees that apply to the Protective Clothing Program: Model Type Submittal Type Application Fee Annual Model Certification Fees Initial $250 $395 Base Model Class I Change $50 N/A Class II Change $50 N/A Initial $125 $125 Variant Model Class I Change $50 N/A Class II Change $50 N/A Initial $125 $125 Accessory Model Class I Change $50 N/A Class II Change $50 N/A 4 of 11

6 26.5 ANSI 101 Limited Use and Disposable Coveralls A. Definition of Model Characteristics that should affect the model s ability to meet the performance requirements of the certification standard: 1. Style Characteristics that should not affect the model s ability to meet the performance requirements of the certification standard: 1. Color 2. Size 3. Material Type B. Examples of Major Components 1. Materials/sizes in which coverall is available C. Laboratory Testing Fees/ Attributes & Variables SEI currently has approved one (1) laboratory that may conduct testing to this standard. The schedule of rates for testing at these laboratories can be found on the SEI website and can be used to estimate the total cost of testing for all the models that are to be certified. 5 of 11

7 26.6 ASTM F2413 Protective Footwear A. Definition of Model Characteristics that should affect the model s ability to meet the performance requirements of the certification standard and therefore require a new model designation: 1. Upper material- composition, thickness or design 2. Sole material- composition, thickness or design 3. Footwear configuration 4. Change in thread type 5. Stud hook/ eyelet- composition or installation method 6. Change in closure method/ materials 7. Change in protective device (e.g., toe cap, shank) 8. Change in adhesives Characteristics that should not affect the model s ability to meet the performance requirements of the certification standard and therefore would not require a new model designation: 1. Color 2. Accessory options (e.g., straps) 3. Size B. Examples of Major Components 1. Upper material listing all layers 2. Color 3. Sizes of each style 4. Threads 5. Sole Materials 6. Closure types 7. Toe cap 8. Ladder shank 9. Sole plates C. Laboratory Testing Fees/ Attributes & Variables SEI currently has approved one (1) laboratory that may conduct testing to this standard. The schedule of rates for testing at these laboratories can be found on the SEI website and can be used to estimate the total cost of testing for all the models that are to be certified. 6 of 11

8 26.7 ANSI/ISEA 107 High Visibility Safety Apparel A. Definition of Model Characteristics that should affect the model s ability to meet the performance requirements of the certification standard and therefore require a new model designation: 1. Style and/or design of visible material 2. Color of visible material 3. Placement and/or design of retroactive material 4. Color of retroreflective material Characteristics that should not affect the model s ability to meet the performance requirements of the certification standard and therefore would not require a new model designation: 1. Visible material type 2. Retroreflective material type B. Examples of Major Components Not applicable for this product C. Laboratory Testing Fees/ Attributes & Variables SEI currently has approved one (1) laboratory that may conduct testing to this standard. The schedule of rates for testing at these laboratories can be found on the SEI website and can be used to estimate the total cost of testing for all the models that are to be certified. 7 of 11

9 26.8 CAN/CSA Z96 High Visibility Safety Apparel A. Definition of Model Characteristics that should affect the model s ability to meet the performance requirements of the certification standard and therefore require a new model designation: 1. Style and/or design of visible material 2. Color of visible material 3. Placement and/or design of retroactive material 4. Color of retroreflective material Characteristics that should not affect the model s ability to meet the performance requirements of the certification standard and therefore would not require a new model designation: 1. Visible material type 2. Retroreflective material type B. Examples of Major Components Not applicable for this product C. Laboratory Testing Fees/ Attributes & Variables SEI currently has approved one (1) laboratory that may conduct testing to this standard. The schedule of rates for testing at these laboratories can be found on the SEI website and can be used to estimate the total cost of testing for all the models that are to be certified. 8 of 11

10 26.9 CAN/CSA Z195 Protective Footwear A. Definition of Model Characteristics that should affect the model s ability to meet the performance requirements of the certification standard and therefore require a new model designation: 1. Upper material- composition, thickness or design 2. Sole material- composition, thickness or design 3. Footwear configuration 4. Change in thread type 5. Stud hook/eyelet composition or installation method 6. Change in closure method/materials 7. Change in protective device (e.g., toe cap, shank) 8. Change in adhesives Characteristics that should not affect the model s ability to meet the performance requirements of the certification standard and therefore would not require a new model designation: 1. Color 2. Accessory options (e.g., straps) 3. Size B. Examples of Major Components 1. Upper material listing all layers 2. Color 3. Sizes of each style 4. Threads 5. Sole Materials 6. Closure types 7. Toe cap 8. Ladder shank 9. Sole plates C. Laboratory Testing Fees/ Attributes & Variables SEI currently has approved one (1) laboratory that may conduct testing to this standard. The schedule of rates for testing at these laboratories can be found on the SEI website and can be used to estimate the total cost of testing for all the models that are to be certified. 9 of 11

11 26.10 NIJ , NIJ Public Safety Bomb Suit Standard Model is the collective term used to identify a group of protective devices of the same basic design and components from a single applicant produced by the same manufacturing and quality assurance procedures that are covered by the same certification. Any characteristic that affects the device s performance under the limits of the current certification standards constitutes a different model. For purposes of the SEI Certification Program, the above definition of the term model uses performance characteristics as the basic criteria. A. Definition of Model Characteristics that should affect the model s ability to meet the performance requirements of the certification standard and therefore require a new model designation: 1. Primary suit material composition, thickness or design including: a. Garment material b. Helmet/Visor material 2. Suit closure type, design and orientation a. Addition of external components including; b. Any component which affects the integrity of the protective suit. Characteristics that should not affect the model s ability to meet the performance requirements of the certification standard and therefore would not require a new model designation: 1. Color (unless pigmenting affects material composition) 2. Size 3. Internal components which do not affect the integrity of the protective suit. B. Examples of Major Components 1. Garment materials include all layers 2. Helmet materials include all layers 3. Closures 4. Seam types 5. Threads 6. Over-cover 7. Boot material 10 of 11

12 26.11 NIJ Criminal Justice Restraints Standard Model is the collective term used to identify a group of protective devices of the same basic design and components from a single applicant produced by the same manufacturing and quality assurance procedures that are covered by the same certification. Any characteristic that affects the device s performance under the limits of the current certification standards constitutes a different model. For purposes of the SEI Certification Program, the above definition of the term model uses performance characteristics as the basic criteria. A. Definition of Model Characteristics that should affect the model s ability to meet the performance requirements of the certification standard and therefore require a new model designation: 1. Primary material composition, thickness or design including: 2. Restraint materials 3. Restraint design Characteristics that should not affect the model s ability to meet the performance requirements of the certification standard and therefore would not require a new model designation: 1. Color (unless pigmenting affects material composition) 2. Size 3. Internal components which do not affect the integrity of the protective suit. C. Examples of Major Components 1. Metallic components 2. Non-metallic components 3. Locking mechanisms 11 of 11

13 26A. SEI General Certification Submittal Form 1307 Dolley Madison Blvd, Suite 3A, McLean, VA Phone: (703) Fax: (703) Submittal Date: SEI Ref. No.: Manufacturer: Legal Status (Inc., LLC, Street Address: City/State/Zip: Tel: Fax: Web: If model is manufactured at different location(s) than stated in Section (2), list all manufacturing locations: Type of Submittal: (select one) Initial: Annual: Standard Rev/Annual: Class I: Class II: Product has not previously been tested by SEI.* Product is currently certified by SEI, is being submitted for annual recertification and no changes have been made to product since last test date. * Product is currently certified by SEI. Standard has been revised and this will also serve as an annual recertification.* Product is currently SEI certified and a change in materials, construction, manufacturing location, etc. has been made to the product. * Product is currently SEI certified and the proposed change is believed to not affect the product s form, fit or function. Category of Product: (select one) Basic model: Variant: Protective device of the same basic design and components, produced by the same manufacturing location. * Variation of basic model distinguished by a single component (i.e., lens shades, suspension systems, reverse headbands, closures, etc.)* Accessory: Product that is for use with a specific SEI certified model, designed in such a manner to be removable from model without affecting the performance of that model in accordance with the applicable standard. * * Definitions are not all inclusive and do not apply to all SEI product certifications. Refer to the SEI Certification Program Manual for additional detailed information and descriptions. 26A Submittal Form

14 26A. SEI General Certification Submittal Form 1307 Dolley Madison Blvd, Suite 3A, McLean, VA Phone: (703) Fax: (703) Standard Testing To: Type of Product: Model Number(s): Brand Name: Product Description. Briefly describe below. Attach applicable Components & Materials Description Checklist, and if applicable, test plan matrix/configurations, Bill of Materials, product literature) Test samples shall be: Returned to manufacturer If fail, return to manufacturer Destroyed by laboratory We request certification or continuation of certification of the above model to the referenced standard in accordance with the program established by the Safety Equipment Institute. We certify that the unit(s) of the above model, as submitted for testing and certification, represents the product(s) that will be offered for sale. Samples of this product are being sent to the laboratory. Please complete all nine (9) sections of the SEI certification submittal form and include any necessary attachments. Incomplete submittal paperwork may lead to delays in the processing and performance testing. Authorized Manufacturer Representative: Signature: 26A Submittal Form

15 26B. General Components Materials Description Checklist Upon completion of this checklist, submit it along with the SEI Certification Submittal Form. Please refer to the Examples of Major Components for suggested product components for which a description is required. Any additional component found in the product shall also be described. 1. SEI Reference Number: 2. Manufacturer (SEI Participant): 3. Model Series/Brand Name (one model per checklist): 4. Standard: 5. Certification Submittal Type (Select one): Initial Annual Change: Class 1: Testing required Class 2: No testing expected to be required For all initial and annual submittals, all sections shall be completed. For changes, complete all sections; mark in BOLD that which has been changed. 6. List all assembly locations, sub-assembly & final product (use separate sheet if needed): 7. List all Model Numbers Description (i.e. color, size, type) *Helmet Positioning Index - Specify either the nose gauge positioning or specify the measurement (mm) from the front rim of the 8. COMPONENT Material Type, Trade Name, Part Number, Grade, Weight, Dimensions, Density, Bead, Color, etc. SOURCE(S) OF SUPPLY (provide complete address, contact info for all source(s) The above information regarding the model is correct to the best of my knowledge. If this model is being submitted for annual testing, I confirm that no known changes that could affect the models ability to meet the performance requirements of the Signed By: Company: Name: Date: 25B CM Form

16 26.5 Label Checklist - Protective Footwear - ASTM F Section Labeling and identification of protective footwear with protective toe cap is essential to ensure the wearer that footwear meets the required minimum performance of this specification (see Table 1). Identification Section 5.1 Product Label Requirements Table 1 Examples of Marking and Identification Description Example A Participant Review SEI Compliant Checklist Line 1 ASTM F Protective footwear that complies with the performance requirement of F2413 issued in Line 2 Line 3 F I/75/C75 EH Footwear worn by female worker which has Impact 75 resistance and Compression 75 resistance. Metatarsal 75 impact resistance and the outsole and heel of this footwear is made with non-conductive materials, electrical hazard resistant. Example B Line 1 ASTM F Protective footwear that complies with the performance requirement of F2413 issued in Line 2 M I/75/C75 Footwear worn by male worker which has Impact 75 resistance and Compression 75 resistance. Line 3 Cd Footwear is conductive The label can be either a stitched in, stamped, or pressure sensitized label or a combination of these methods. A specific four line format that identifies the type of footwear and the hazards for which it is designed to provide protection should be used. The identification shall be enclosed in a rectangular border and be placed on the inside or outside surface of either the tongue, gusset, shaft or quarter lining in one half pair. Print size on labels shall be clearly visual to the eye and shall measure mm (0.125 in.) or larger. For example: Measurement: Line 1 Identifies that the footwear is protective footwear that complies to an ASTM standard with a specific year of issuance. ASTM F (ASTM Standard No.) (Year of issuance) 26C ASTM F2413 LUT Form

17 26.5 Label Checklist - Protective Footwear - ASTM F Line 2 of label shall identify the appropriate gender and the impact and compression rating of the category. M I/75/C/75 M I 75 C Male Impact Resistant Impact Compression Compression Footwear Rating Resistant Rating Footwear F I 75 C 75 Female F I/75/C/75 Impact Resistant Impact Compression Compression Footwear Rating Resistant Rating Footwear Lines 3 and 4 have been used to reference additional sections in this standard. Section reference shall be in numerical order. (I) Identifies protection against impact as discussed in 5.1. (C) Identifies protection against compression as discussed in 5.2. (Mt) Identifies footwear designed to be impact resistant to the top of the foot as (Cd) Identifies protection against conductive hazards as discussed in 5.4. (EH) Identifies footwear constructed with and manufactured to have electrical insulation properties; electrical hazard resistant as discussed in 5.5. (SD) Identifies footwear designed to reduce the accumulation of excess static electricity as discussed in 5.6. (PR) Identifies footwear designed to be puncture resistant as discussed in 5.7. Line 4 shall be used when more than 3 sections of this standard apply to any one category FOR SEI USE ONLY INITIAL LABEL REVIEW COMPLY / NOT COMPLY (do not sign if deemed not comply ) COMMENTS: Prepared by & Date: Reviewed by & Date: Measuring Device ID Number: SUBSEQUENT REVIEW (LABEL) COMPLY / NOT COMPLY (do not sign if deemed not comply ) COMMENTS: Prepared by & Date: Reviewed by & Date: Measuring Device ID Number: 26C ASTM F2413 LUT Form

18 26C LABEL, USER INFORMATION, AND TECH DATA PACKAGE CHECKLIST NIJ Public Safety Bomb Suit Standard PARTICPANT NAME: SEI REFERENCE NUMBER: NAME/MODEL/DESCRIPTION: Section 7.1 General Product Label Requirements for Bomb Suit Section Models Each detachable protective element of the bomb suit, with the exception of the face shield, shall have a product label permanently attached to, embossed on, or printed on an inside surface. The face shield shall have a product label permanently attached to, embossed on, or printed on it in letters at least 2 mm (1/ inch) high. The product label shall include at least the model number and serial number. All worded portions of a required product label shall appear in English, but other languages may be added. Symbols and other graphical information may be used to supplement text on the product label(s) and shall be explained in the user information. For each compliant bomb suit model, each certified-product label shall include the applicable compliance and information statements specified in Section 7.2. In addition to the compliance and information statements required by Section 7.1.5, each detachable protective element of the bomb suit, with the exception of the face shield, shall have at least the following information printed legibly on the product label(s) in letters a minimum of 3.2 mm (1/8 inch) high: (1) Name and legal address of the supplier (2) Address of manufacturing location (city, state/province, country) (3) Date of manufacture (i.e., month and year) (4) Bomb suit model number If the bomb suit model has detachable protective elements, the bomb suit product label shall include the detachable protective element model (4)a numbers for the protective elements that must be used in order for the bomb suit model to be compliant (5) Serial number for the bomb suit (6) Size (7) Assembly orientation of any protective element if necessary for performance requirements of this standard (e.g., strike face, wear face) Participant Review Measurement: Measurement: SEI Compliant Checklist Measurement: Measurement: 26C NIJ 0117 LUT Form

19 26C LABEL, USER INFORMATION, AND TECH DATA PACKAGE CHECKLIST NIJ Public Safety Bomb Suit Standard Section Section 7.2 Compliance Statements on Certified Product Labels of Compliant Bomb Suit Models Participant Review SEI Compliant A certified product shall have the following compliance statement on the bomb suit product label in letters at least 2.5 mm (3/32 inch) high. Measurement: Measurement: PURSUANT TO NIJ CR , THIS BOMB SUIT MODEL HAS BEEN TESTED AND FOUND TO BE COMPLIANT WITH THE REQUIREMENTS OF NIJ STANDARD (PUBLIC SAFETY BOMB SUIT STANDARD). DO NOT REMOVE THIS LABEL (Certification) (Certification) The certification body shall require its mark of conformity to be part of, attached to, or immediately adjacent to a product label that otherwise satisfies the requirements for labeling in NIJ Standard The certification body shall require its mark of conformity to be legibly printed. Section Section 7.3 User Information Requirements Participant Review / Page # / Paragraph SEI Compliant Checklist In order to have a bomb suit model tested under this standard, the supplier must agree that, if the model is found to be compliant, it will provide written user information including, but not limited to, warnings, information, and instructions with each individual bomb suit (and with The supplier shall provide the required user information in such a manner as to make such information clear, prominent, and immediately available to any individual opening the package (1) 7.3.3(2)a 7.3.3(2)b 7.3.3(2)c 7.3.3(2)d The supplier shall provide at least the following warnings, information, and instructions as part of the written user information: List of required accessories provided with the bomb suit or protective element Pre-use information: Safety considerations Pre-use information: Recommendations and precautions regarding the application of public safety agency markings after purchase Pre-use information: Any limitations or precautions as to type(s) of clothing worn under the bomb suit Pre-use information: Description of mechanism(s) to prevent condensation on the face shield 26C NIJ 0117 LUT Form

20 7.3.3(2)e 7.3.3(3)a 7.3.3(3)b 26C LABEL, USER INFORMATION, AND TECH DATA PACKAGE CHECKLIST NIJ Public Safety Bomb Suit Standard Pre-use information: Warranty information, including length of warranty Don/doff, as follows: Donning and doffing procedures, including quick doffing and incapacitated doffing, and any bomb suit protective element interface considerations Don/doff, as follows: Sizing and adjustment procedures 7.3.3(4) Instructions for proper use as intended by the supplier 7.3.3(5)a Care and maintenance, as follows: Cleaning instructions and precautions 7.3.3(5)b 7.3.3(5)c 7.3.3(5)d 7.3.3(5)e 7.3.3(5)f Care and maintenance, as follows: Recommended decontamination procedures Care and maintenance, as follows: Recommended storage conditions Care and maintenance, as follows: Inspection details Care and maintenance, as follows: Repair methods, where applicable Care and maintenance, as follows: Retirement and disposal criteria and considerations Section Section 7.4 Technical Data Package Requirements Participant Review / Page # / Paragraph SEI Compliant Checklist In order to have a bomb suit model tested under this standard, the supplier must agree that, if the model is found to be compliant, it will furnish, as set forth in this section, a technical data package for the bomb suit model upon the request of the purchaser or the prospective purchaser. The technical data package shall contain all data showing compliance of the model with this standard. In the technical data package, the supplier shall describe the bomb suit model in terms of the supplier name, trade name, model number, supplier-replaceable protective elements and components, and available sizes. Descriptions of size shall include the ranges in height and weight for persons fitting each particular available size of bomb suit The technical data package shall include a list and descriptions of the following with respect to the bomb suit model, as applicable: (1)a All protective elements and components: Face shield: Permanent or removable appliqués or films (1)b All protective elements and components: Protective element and component methods of attachment (2) Required accessories 26C NIJ 0117 LUT Form

21 26C LABEL, USER INFORMATION, AND TECH DATA PACKAGE CHECKLIST NIJ Public Safety Bomb Suit Standard FOR SEI USE ONLY INITIAL LABEL REVIEW COMPLY / NOT COMPLY (do not sign if deemed not comply ) COMMENTS: Prepared by & Date: Reviewed by & Date: Measuring Device ID Number: INITIAL USER INFORMATION REVIEW COMPLY / NOT COMPLY (do not sign if deemed not comply ) COMMENTS: Prepared by & Date: Reviewed by & Date: Measuring Device ID Number: INITIAL TECHNICAL DATA PACKAGE REVIEW COMPLY / NOT COMPLY (do not sign if deemed not comply ) COMMENTS: Prepared by & Date: Reviewed by & Date: Measuring Device ID Number: SUBSEQUENT REVIEW (LABEL / USER INFORMATION/TECHNICAL DATA PACKAGE) COMPLY / NOT COMPLY (do not sign if deemed not comply ) COMMENTS: Prepared by & Date: Reviewed by & Date: Measuring Device ID Number: 26C NIJ 0117 LUT Form

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