NOTIFICATION OF BIOCIDAL PRODUCTS

Regulation (EU) No528/2012 of the European Parliament and of the Council of 22 may 2012 concerning the making available on the market and use of biocidal products. This is not an approval of the product. Authorisation (or mutual recognition) must be applied for according to the regulations.

NorwegianRegulation:Forskrift om biocider (biocidforskriften)

Send to:

The Product Register

Norwegian Environment Agency

P.O. box 6257 Etterstad,N-0603 OsloShaded box to be used by the Product Register

Norway

Phone: + 47 73580500

Declaration number (if the product already is in the register):

Box 1: One or several types must be given i box 1.

2. Trade name of the product: / 3. Classification of the product
Box 2: Give the complete trade name as shownon the warning label. / Box 3: Give the classificationaccording to the product label. If the product is not classified give NC.
4. Company responsible for placing the biocidal product on the market in Norway: / Enterprise no.:
Telephone:
Fax:
Email address:
Contactperson:

Box4: Give name, postal address and other necessary information on the company.

5. Manufacturer:
Company name: / Telephone:
Address: / Fax:

Box5: Give name, postal address and other necessary information for the actual manufacturer of the product. Voluntary information.

6. Quantities: / Imported to Norway as tonnes/year:
Figures for year: / Produced (in Norway) as tonnes/year:
Box 6: Voluntary information if the product is given as not classified in box 3.
8. Branches of industry where used (one line per branch): / Branch code / %-distribution
Is the product also used for non-occupational purposes? / YES: / NO:
If «YES», give the percentage of non-occupational purposes: / PR1
Sum 100%
Box 8: Give the branches of industry that you judge to be most important, use key words. (codes: see: )Voluntary information
9. Active substances:
No. / Identity number
CAS-no. EC-number / Unambiguous chemical name / Classification
(symbol letter and R-phrases) / Weight-%

Box 9: Active substances must be given with their unambiguous chemical name, identity number, classification and exact

percentby weight.

10. Confidentiality and signature:
Does this form have information that you want to keep confidential? Yes No
Information available from other sources (e.g. safety data sheet or label) will normally not be confidential. According to
Article 66 in 528/2012, information about active substancescannot be confidential and should be printed on the label upon approval. Information that is not specified as confidential will be treated as public information.
Subject (box no) / Business-secret (tick box) / Reason why the information shall be kept confidential
I hereby confirm that the information given above is correct and changes shall be sent to the NorwegianEnvironment Agency. I understand that all documentation of relevance to the completion of the form shall be available in the company. The authorities may require such documentation to be submitted on request..
For the company
Date: / Person responsible for declaration:
Signature

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