Materials Testing Form

100 East Glenside Avenue, Glenside, PA. 19038 USA
Tel: 1 (215) 517-8700 | Fax: 1 (215) 517-8747 | info@solarlight.com | www.solarlight.com

MATERIALS TESTING FORM

Date: ___________________

From: (Complete name and address)

Person name: _______________________________

Company name: _____________________________

Street Address: ______________________________

City: ________________________ State: _________Postal code: ________

Country: _________________________

Telephone: ____________________ FAX No. _______________________

E-Mail: ______________________________

Payment Information:

Credit Card: MasterCard / Visa / Amex / Discover

Credit Card #____________________________________ Exp. _________

PO # _____________________________

Testing required: (Please check off the type of testing required)

[ ] Accelerated UV testing of a material;

Years to simulate ____________ Tropical ___ or Temperate Zone___

Please circle all that apply below:

Photography to be taken after: Yr 1 Yr 2 Yr 3 Yr 4 Yr 5

Colorimetry measurement after: Yr 1 Yr 2 Yr 3 Yr 4 Yr 5

Sample Removed and returned: Yr 1 Yr 2 Yr 3 Yr 4 Yr 5

Number of Samples being sent to Solar Light Co:________

Detailed Report by Engineer/Physicist (Extra Charge) Y / N

[ ] Spectral light transmission characteristics of a material;

Wavelength range_____nm to ______nm ______nm step size.

[ ] Spectral response of a detector;

Wavelength range_____nm to ______nm ______nm step size.

[ ] Spectral output of a light source;

Wavelength range_____nm to ______nm ______nm step size.

Other (explain below):

___________________________________________________________________

List the items being sent in for testing and the relevant area of exposure:

1. Description:_______________________________________________________

___________________________________________________________________

2. Description:_______________________________________________________

___________________________________________________________________

3. Description:_______________________________________________________

___________________________________________________________________

4. Description:_______________________________________________________

___________________________________________________________________

Return Shipping Instruction:

Ship to address: (Complete name and address) Check if same as above _______

Person name: _______________________________

Company name: _____________________________

Street Address: ______________________________

City: ____________________ State: _________________ Postal code: _________

Country: _________________________

Telephone: ______________________ FAX No. _____________________________

E- Mail: _________________________________________

COMMENTS: __________________________________________________

___________________________________________________________________

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Note: Please include a copy of this form with your samples being sent for testing.