Notification Form for Biocidal Products

Product (brand name): ..........................…………………………...........................….............................................

Biocide product type(s): (select from list of categories attached - enter type numbers) …….….………..........…..

Formulation Type (GCPF Code): (e.g. EC, SC, wax block, paint etc.) .................….......………………………...
 
Brief description of intended use(s): ............….................................................................................................…...
............…..................................................................................................................................................................

Name and address of the formulator (manufacturer) of the biocide product: .………….........................................
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Notifier: ............…...................................................................................................................................................
..................................................................................................................................................................................

Primary wholesale distributor (s): ...........................................................................................................................
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Pack sizes	Packaging type (materials and construction)	

		

For Amateur Use:	Yes	No	For Professional Use:	Yes	No

Material Safety Data Sheet (MSDS) for the biocide product enclosed:	Yes	No

Current/proposed product label (in compliance with the Regulations) enclosed:	Yes	No

For Official Use
 
  PCS No:	…………………………………………………………………………………………………….

  Category: 	…………………………………………………………………………………………………….

  Reference product: 	…………………………………………………………………………………………………….

  Associated products: 	…………………………………………………………………………………………………….

  Initials: 	…………………………………………………………………………………………………….

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Detailed Specification of the preparation:
Identity of each substance in the preparation *	CAS number	Manufacturer of the active substance 	minimum content of technical material 
(g/kg)	minimum content of pure technical material
(g/kg)	MSDS enclosed
(indicate yes or no)	Letter of access enclosed (if required -yes or no)	
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Identity of each formulant (other than active substance) in the preparation *	Trade name (if applicable	CAS number	Manufacturer of the formulant	function of the formulant	minimum content of formulant  
(g/kg)	MSDS enclosed
(indicate yes or no)	Letter of access enclosed (if required -yes or no)	
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Detailed specification of each active substance in the product (to be completed for each such active substance – repeat page 3 for each active substance)
Active substance:                                                                                                   	
Identity of each by-product or impurity* in the active substance 	maximum content in g/kg	
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Identity of each inactive isomer* in the active substance	maximum content in g/kg	
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Ratio of the content of isomers/diastereoisomers: (specify)                                                                                    	
Identity of each additive* in the active substance	maximum content in g/kg	
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*	ISO common names, where available should be used, in other cases the chemical name of 
    each constituent (EINECS or ELINCS), and the CAS and EC numbers should be provided 

Details of the manufacturing process (synthesis pathway) for each active substance in the biocide product (to be completed for each such active substance – repeat page 4  for each active substance):
Active substance:                                                                                                                                 	
Identity of each starting material* in the active substance	
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Brief description of the chemicals pathways involved	

	
Identity of by-products and impurities present in the final product *	
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*	ISO common names, where available should be used, in other cases the chemical name of 
    each constituent (EINECS or ELINCS), and the CAS and EC numbers should be provided 

Biocide Products by Type

(Each biocide product notified should be identified as being of one or more of the following product types  - see second item on page 1 of the notification form) 

Type 1	Human hygiene biocidal	biocidal products used for human hygiene purposes
	products

Type 2	Private area and public	products for disinfection of air, surfaces materials, equipment and 
	health area disinfectants 	furniture (excluding uses involving direct contact with food or feed), in private, public, and industrial areas including hospitals and algaecides (e.g. use in swimming pools, aquaria, bathing and other waters, air conditioning systems, walls and floors, chemical toilets, waste water, hospital waste, soil or other substrates

Type 3	Veterinary hygiene biocidal	biocide products used for veterinary hygiene purposes including products 
	products 	used in areas in which animals are housed, kept or transported

Type 4	Food and Feed area	products used for the disinfection of equipment, containers, consumption 
	disinfectants 	utensils, surfaces or pipework associated with the production, transport, storage or consumption of food, feed or drink (including drinking water) for humans and animals 

Type 5	Drinking water disinfectants	products for disinfection of drinking water for humans and animals

Type 6	In-can preservatives	products for preservation of manufactured products other than foodstuffs or feedingstuffs, in containers, via control of microbial deterioration - to ensure shelf life

Type 7	Film preservatives	products used for the preservation of films or coatings by the control of microbial deterioration in order to protect the initial properties of the surface of materials or objects such as paints, plastics, sealants, wall adhesives, binders, papers, art works

Type 8	Wood preservatives	products used for the preservation of wood, from and including the saw-mill stage, or wood products by the control of wood-destroying or wood- disfiguring organisms (preventative and curative products)

Type 9	Fibre, leather, rubber	products used for the preservation of fibrous or polymerised materials, 
	and polymerised	such as leather, rubber or paper or textile products and rubber by the 
	materials preservatives	control of microbiological deterioration

Type 10	Masonry preservatives	products used for the preservation and remedial treatment of masonry or other construction materials other than wood by the control of microbiological and algal attack

Type 11	Preservatives for liquid	products used for the preservation of water or other liquids used in 
	-cooling and processing	cooling and processing systems by the control of harmful organisms such 
	systems 	as microbes, algae and mussels - does not include products used for the preservation of drinking water

Type 12	Slimicides	products used for the prevention or control of slime growth on materials, equipment and structures, used in industrial processes e.g. on wood and paper pulp, porous sand strata in oil extraction

Type 13	Metalworking-fluid	products used for the preservation of metalworking fluids by the control 
	preservatives	of microbial deterioration

Type 14	Rodenticides	products used for the control of mice, rats or other rodents

Type 15	Avicides	products used for the control of birds

Type 16	Molluscicides	products used for the control of molluscs

Type 17	Piscicides	products used for the control of fish; these products exclude products for the treatment of fish diseases

Type 18	Insecticides, acaricides and 	products used for the control of arthropods (e.g. insects, arachnids and
	products to control other	crustaceans)
	arthropods

Type 19	Repellents and attractants	products used to control harmful organisms (invertebrates such as fleas, vertebrates such as birds), by repelling or attracting, including those that are used for human or veterinary hygiene either directly or indirectly

Type 20	Preservatives for food or	products used for the preservation of food or feedstocks by the control of 
	feedstocks 	harmful organisms

Type 21	Antifouling products	products used to control the growth and settlement of fouling organisms (microbes and higher forms of plant or animal species) on vessels, aquaculture equipment or other structures used in water

Type 22	Embalming and taxidermist	products used for the disinfection and preservation of human or animal 
	fluids 	corpses, or parts thereof

Type 23	Control of other vertebrates	products used for the control of vermin