7/18/2019 ARC TEST FORM 2011.doc

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Complete one form per rating *This information will appear on the test report as it appears belo

Billing and Contact Information – (the report will be sent to this address)Name  Company Address 

City, State/Province Zip  ,CountryPhone  E-mail

Report Contact information as you want it to appear on the nal report (ifdierent than above)Name  Company

 AddressCity, State/Province Zip ,CountryPhone E-mail

Test to be conducted:

abric Testing !ther Testing F199 Textiles (per !"#$%

 F199 &ain'ear or laminated materials (per !)!% 

!EC "1#$%-1-1 &ethod A

(*aterial must already +e 'ashed% 

Scoutin' (reuires panels per shot %. o Shots

&atin0 tryin0 to achieve

F$$( (all Protection 1arness%

 F%"%1 (2arment Evaluation%

 !EC "1#$%-1-1 &ethod )(2arment Evaluation%

 F%1($ (1oods, 2o00les and ace shields%

 F**** 2love Test

 Scoutin' (*anneuin tests include 3 shirts per shot%

. o Shots

&atin0 tryin0 to achieve

Proceed to Part A - Fa+ric "roceed to "art B – !ther Testing

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"art # – abric Testing only Arc4ear to launder5 6es

ash / 1 dry .AACC &ethod 10

ther

No7aundry *ethod 8sed

 Arc4ear to cut panels5 6es No

Special 9nstructions:

abric $escription:Layer 1: (Top Layer)Manufacturer:Nominal Weight: oz/yd2 or 

g/m2

tyle No!"a#ric Type: $nit Wo%en Non&Wo%en

"a#ric 'ecription (i!e! erey* plain +ea%e* t+ill,):"i#er -ontent and .ercentage of ach "i#er:-olor:

If multi%layered system& please complete ne't page#dditional fees for ratings *+ cal,cm- and laminated fabrics re.uiring#/T0 1231 testing

"art # – abric Testing only (for additional layers)abric $escription:Layer 2: (econd Layer)Manufacturer:Nominal Weight: oz/yd2 or 

g/m2

tyle No!"a#ric Type: $nit Wo%en Non&Wo%en

"a#ric 'ecription (i!e! erey* plain +ea%e,):"i#er -ontent and .ercentage of ach "i#er:-olor:

abric $escription:Layer 0: (Third Layer)Manufacturer:Nominal Weight: oz/yd2 or 

g/m2

tyle No!"a#ric Type: $nit Wo%en Non&Wo%en

"a#ric 'ecription (i!e! erey* plain +ea%e,):"i#er -ontent and .ercentage of ach "i#er:

-olor:

If more than three layers& add more sections by copy and paste

"art B – !ther TestingSpecial 9nstructions:

;escri+e each item to +e tested, includin0 type o item, style or identiication num+er, i+er content, colorand any inormation to +e included in the report<

1! Target ating

2! Target ating

0! Target ating

! Target ating

3! Target ating

4! Target ating

If more than si' items& add more sections by copy and paste

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 Tet eport +ill #e ent #y email and tored in your account at +++!arc+earonline!com! T

ha%e a paper copy ent to you at an additional fee:

Num+er o Copies: (elect all that apply)

 Notari=ed Arc4ear Company Seal