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Microbiological Test Request Form Name of Applicant (or Report Title): Address: Person to Contact: Tel: Ext.: Invoice to: same as above Address: Person to Contact: Tel: Ext: Sample General Description (ex. Polyester Material) Return Sample: No Yes (1. (Default: No if unselected) 2. Intertek Internal use only Project No.: E-mail: Please e-mail this completed form or any questions to [email protected] E-mail: Item/Style No. (ex. PES598-BL31) Quantity of Sample Submitted By client within one month after report issued or sample will be destroyed automatically; By Intertek with client shipment account: Bacterial Test Methods Fungal Test Methods AATCC 147 for Textiles: Antibacterial Activity Assessment of Textile Materials: Parallel Streak Method AATCC 30 Test III for Textiles: Antifungal Activity, Assessment on Textile Materials: Mildew and Rot Resistance of Textile Materials Added Glucose AATCC 100 for Textiles: Assessment of Antibacterial Finishes on Textile Materials IAC Recommended Method (K.pneumonia replaced by E.coli) ASTM G21 for Synthetic Polymeric Materials: Determining Resistance of Synthetic Polymeric Materials to Fungi JIS L1902 for Textiles: Testing Antibacterial Activity and Efficacy on Textile Products (Qualitative Method) ASTM D3273 for Interior surface coatings: Standard Test Method for Resistance to Growth of Mold on the Surface of Interior Coatings in an Environmental Chamber JIS L1902 for Textiles: Testing Antibacterial Activity and Efficacy on Textile Products (Quantitative Plating Method) ASTM C1338 for Insulation materials: Standard Test Method for Determining Fungi Resistance of Insulation Materials and Facings JIS Z2801 for Plastics: Testing Antibacterial Activity and Efficacy on Textile Products ASTM D4300 for Adhesives: Ability of Adhesive Films to Support or Resist the Growth of Fungi Procedure for Meeting Government Specifications? ASTM E1428 for Plastics: Standard Test Method for Evaluating the Performance of Antimicrobials in or on Polymeric Solids Against Staining by Streptomyce species ASTM E2149 for Textile/Plastics: Standard Test Method for Determining the Antimicrobial Activity of Antimicrobial Agents Under Dynamic Contact Conditions ASTM E2180 for Non-porous Materials: Standard Test Method for Determining the Activity of Incorporated Antimicrobial Agent(s) In Polymeric or Hydrophobic Materials ASTM G22 for Synthetic Polymeric Materials: Standard Practice for Determining Resistance of Plastics to Bacteria ISO/DIN 20743 for Textiles : Textiles -- Determination of antibacterial activity of textile products Others: ISO 846 Method B (fungi resistance): Plastics – Evaluation of the Action of Microorganisms MIL 810G 508.7 Fungus (Table I Organisms) – Contact for Pricing and chamber availability prior to sample submission Others: Test Protocol Information All tests will proceed utilizing the default organisms and incubation parameters specified by the selected standard unless otherwise noted. Additional organisms are avalable upon request, up to and including BSL-2 bacteria, fungi and virus. Intertek will provide default negative and positive control material if not provided by the client. Sample Requirements Textile Test Method – 0.5 yards of fabric Polymeric/Plastic Test Method – 9 pieces of 2 x 2 inch ASTM D4300 – 250mL of Sample ASTM D3273 – 3 x 4 inch in triplicate. Sample Shipment Information Attention: Nicholas Unger Intertek Testing Services 1717 Arlingate Lane, Columbus, Ohio, 43228 Report Options : Photo on report of representative sample Photos on report of before and after test Photo request of microbes in agar plate : No Yes Default: No if unselected [Charged Additionally] Separate reports generated per sample? : No Yes Default: No if unselected [250.00 USD Per Report] Turnaround time: Bacterial Test Methods 7-10 Business Days. Fungal resistance : 28-35 Business Days (Based on 28 day incubation time required by standard). Extra 3-5 Business days will be added when a test modification is requested. (Authorized signature) (Date): Intertek Testing Services 1717 Arlingate Lane, Columbus, Ohio, 43228 Tel: 614-279-8090 Fax: 614-279-4642 Web: www.intertek.com Valued Quality Delivered