Cradle to Cradle Certified Material Health Certificate

Assessment Summary Form

Applicant Company:	[Company]
Product:	[Product]
Submission Date:	[Date Submitted]

Form last revised: November 2021

Cradle to Cradle Products Innovation Institute

CONFIDENTIAL AND PROPRIETARY—For use only by [Applicant Company], [Assessment Body(ies)], and the Cradle to Cradle Products Innovation Institute.

Assessor Attestation

I hereby certify under penalty of law, that to the best of my knowledge and belief:

All information provided in this assessment, on behalf of the company identified below, is complete and accurate.

Except as may be otherwise indicated, this assessment fully conforms with the requirements of ISO 17065, the Material Health Certificate Standard (‘Standard’), and the Material Health Certificate Program (‘Program’) documents. The assessment procedures of the standard and program documents were followed without deviation and the application of such procedures did not indicate any conditions of non-compliance with the requirements of ISO/IEC 17021-1 and 17065, the Standard, or Program documents.

This assessment was conducted in conformance with all requirements of the Program, as well as the impartiality requirements of ISO/IEC 17021-1 and 17065. There were no conflicts of interest present between the individuals that conducted the assessment and the certification client or their material suppliers.

BY SUBMITTING A SIGNED COPY OF THIS ASSESSOR ATTESATION AND ASSESSMENT YOU HEREBY AGREE TO THE TERMS, CONDITIONS AND PROVISIONS REPRESENTED IN THIS ASSESSOR ATTESTATION. YOU ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTOOD THIS ASSESSMENT AND ALL EXHIBITS AND SCHEDULES HERETO, ALL PROGRAM POLICIES AND GUIDELINES, INCLUDING THE STANDARD AND ASSESSMENT METHODOLOGIES, AND TRADEMARK USAGE POLICY APPLICABLE TO THE ASSESSMENT, AND THAT YOU HAVE BEEN PROVIDED THE OPPORTUNITY TO MAINTAIN A RECORD OF THIS ASSESSOR ATTESTATION.

By:

Assessor Signature:_____________________________

Date:	[Date of signature]
Assessor name:	[Name of individual signing]
On behalf of Assessment Body:	[Name of assessment body]

Instructions

Purpose

This document is the form for submitting an assessment summary for a product applying for a Material Health Certificate according to Version 3.1 of the Material Health Certificate Standard (‘the standard’). The intention is that an accurately completed form contains all of the information required for third-party review by the Cradle to Cradle Products Innovation Institute (C2CPII) for the purposes of awarding certification.

Assessor Attestation

On the second page, please insert your digital signature (as an image) in the place provided. No submission will be accepted without the assessor’s signature included. Alternatively, you may convert the completed document to PDF and add your signature in Adobe or similar software.

General Guidance

This form contains general instructions for providing information to support a certification decision. Please refer to the standard for detailed guidance on required methods, documentation, and the definitions of certification criteria.

Instructions are provided in italics throughout the application. Follow the instructions and complete the form using the checkboxes, drop-down menus, and text boxes provided. Please also note that placeholder text on the title page (‘Applicant Company’ and ‘Assessment Body(ies)’) needs to be replaced with the appropriate, applicable information prior to submission.

Recertification

This form is also to be used for recertification applications. For recertification, the application must demonstrate the fulfillment of each individual requirement and also highlight changes and progress that occurred with respect to the previous certification of this product or product group.

Updates on all optimization strategies must be provided (sections 5.9, 6.3/6.4, 7.3, 8.8/8.10, and 9.3). Specific progress must be shown on the Material Optimization Strategy (section 6.3) for products that have not yet obtained the Gold or Platinum level in the Material Health category and in at least one of the other categories otherwise. If any problems were identified during the local- and business-specific water issues characterization or the streamlined self-audit, progress must also be shown in those areas at recertification. Note that documentation and numbers on energy use, water audits, emissions, purchased RECs, and offsets need to be updated for every recertification, including applications submitted for Platinum products.

Documentation Guidelines

Where required, supporting documentation that needs to be submitted to demonstrate fulfillment of a given requirement is called out in the corresponding prompt in bold with an underline, and a document icon (example: Submission Authorization form signed by the applicant is attached). Supporting documents may be submitted as separate attachments alongside the completed assessment summary form. If required documentation is attached separately, enter the filename in the fields provided. If any separate files are submitted that do not correspond with the information types for which filename fields have been provided, please indicate the purpose of these files and filenames in the assessor notes sections or other relevant locations. Follow a systematic naming format. The suggested format is the following: ‘Section code’_’Document type’_’Company name’_’Product name’_’year’.pdf. Here is an example: ‘MH_BOM_AcmeCo_iAnvil_2015.pdf’. See the table below for a list of section codes.

Section Name	Section Number	Section Code
General/Administrative	Section 1 & 2	GA
Material Health	Section 5	MH
Material Reutilization	Section 6	MR
Renewable Energy & Carbon Management	Section 7	RECM
Water Stewardship	Section 8	WS
Social Fairness	Section 9	SF
Recommendations for Product Optimization	Section 10	RPO

Assessor Notes

At the beginning of each section is a text field with the placeholder text ‘Assessor Notes’. These fields may be used by the Assessor to make notes during the assessment process. For example, this field can be used to leave reminders regarding missing items or fields that still need to be filled in. Typically, such notes should be removed prior to submitting the completed assessment to C2CPII. However, in the rare cases in which additional information needs to be provided to the auditor that does not fit into any of the other fields, these fields may also be used for this purpose. In such cases, please include a clear explanation of why the additional information is needed for the auditor.

Application Submission

After all required information has been included in this assessment form:

Thoroughly review the form to ensure it does not contain inaccurate information, typos, omissions, or remaining replaceable text.

In order to update the Table of Contents and conduct a final Spellcheck:

For Mac Users: you may unlock the document using the Tools menu, and selecting “Protect Document” or by using the keyboard shortcut “Command” + “\”

For PC Users: Go to the Review tab in MS Word, then click on Restrict Editing tab on left of screen and uncheck editing restriction.

Update the table of contents to reflect current page numbers (right click on TOC and select ‘update field’).

Run document Spellcheck

Convert the filled-out form to a PDF file. Note: Non-PDF versions of the ASF will not be accepted.

Name the file following this convention: AS_’Product name’_’Date submitted (YYMMDD)’.pdf.

Submit the completed form and all supporting documentation (total file size not to exceed 25 MB) in a single email to certification@c2ccertified.org, with applicant company and product name in the subject line.

Other forms that may be required:

Assessment Report Submission Authorization Form

Externally Managed Component Form

VOC Emissions Testing Form

Bill of Materials Template

Supplier Banned List Declaration Form

Table of Contents

1	Version Control & Overview	1

2	Contacts	2

2.1	Lead Assessment Body	2

2.2	Material Health Assessment Body	3

2.3	Applicant	3

3	Product Information	4

3.1	Products Covered in this Application	4

3.2	Product Registry Information: Description and Image	5

3.3	Product Category(ies) or Classification	6

3.4	Packaging	6

3.5	Certified Product Private Label Verification	7

4	Manufacturing Site(s)	8

4.1	Site Visit(s) – Optional for Material Health Certificates	8

4.2	Final Manufacturing Stage of Product	9

4.3	Final Manufacturing Stage Facilities	9

5	Material Health	10

5.1	Overview	10

5.2	Product Metabolism (Basic)	11

5.3	Banned List Compliance (Basic)	11

5.4	ABC-X Assessment Results (Bronze)	14

5.5	Material Health Certificate Table	19

5.6	Hazard and Risk Assessment Considerations (Bronze)	22

5.7	Determining Absence of CMR Substances (Silver)	25

5.8	Volatile Organic Compound (VOC) Emissions Testing (Gold)	27

5.9	Process Chemicals Assessed and not x-Assessed (Platinum)	27

5.10	Material Optimization Strategy (Bronze)	28

Version Control & Overview

[assessor notes]
Instructions: Provide the application version history for this certification in the table below. Begin by filling in the original date of submission for this application for certification/recertification. If additional versions of this ASF are submitted after the initial submission during the review process, add an entry to the table for each version, noting the reason for the additional submission. Required for Interim Assessment Reviews (IAR): Describe the specific changes requiring an updated ASF submission in the Reason for Submission column below (e.g., certificate correction, merging or splitting of certificates). Please provide sufficient detail and indicate what sections of the ASF have been updated. Required for recertifications: Provide a high-level summary of the major changes that occurred since the last certification and list the relevant sections where these major changes were made. If more efficient to highlight these changes throughout the report, this would be acceptable as an alternative. [...]
Version Number	Date Submitted	Reason for Submission
1	[...]	[...]
2
3
4
5
Instructions: Provide an overview of this application by filling out the table below. Additional information regarding what to enter in each row is provided below:
Purpose of Application
Version of Standard used
Recommended Material Health Certificate level
Assessment start date This is the date on which the final Bill of Materials was received by the Assessment Body.	[...]
Certification start date The default is for new certifications and interim assessments to be issued and appear on the public registry immediately upon approval. If the applicant wants to hold certification issuance and publication until a later time, indicate this here and enter the desired issuance date in this row (Note: the date may be no more than six months after the assessment package submission date).	Issuance date: [...]
Note: Any additional information not covered elsewhere in the application, but necessary for understanding the nature of the application, may also be included in paragraph form in the space below (e.g., if the application is needed to support the addition, exclusion, or re-grouping of products with respect to the previous certification or if the application is submitted at an irregular time for the purpose of a mid-certification period level change). If the purpose of the application is stated as 'other,’ this should be explained in a separate paragraph here.
[...]

Contacts

[assessor notes]

Lead Assessment Body

Instructions: Provide the contact information for all individuals involved in this assessment and application preparation by replacing the placeholder text with the indicated information. The project manager of the lead assessment body, the materials assessment lead of the materials assessment body, and the company contact will be the ones receiving audit communications. Ensure that the applicant’s address is the current billing address, because it will be used for invoicing.
Company:	[company name]
Project Manager [required]:	[name], [title], [email], [phone number]
Final Assessment Sign-off [required]:	[name], [title], [email]
Other Individuals Involved in Assessment:	[name], [title], [company name (if different from above)]
Required: An individual other than the individual doing the majority of the assessment work has reviewed this assessment summary. Final assessment sign-off was by an individual trained/accredited by C2CPII (and named in the table above).

Material Health Assessment Body

Instructions: Complete this section only if the Material Health assessment was conducted by a company other than the lead assessment body indicated in section 2.1. Otherwise, write: “Same as Lead Assessment Body.”
Company:	[company name]
Material Health Assessment Lead:	[name], [title], [email]
Other Individuals Involved in Assessment:	[name], [title]
Required for new and recertifications: The Material Health Assessor Attestation Form has been completed and signed by the Cradle to Cradle Certified Material Health assessor that conducted the material health assessment for this product/product group. The filename is: [...].

Applicant

Instructions: Provide the contact information for the applicant company and all relevant company contacts. This needs to include the person to whom the Certification Agreement for this certification should be sent. If multiple contacts are provided, indicate to whom the agreement should be directed. The ‘accounts payable contact’ is the person at the applicant organization to whom C2CPII should send invoices for certification-related fees.
Company Name:	[company name]
Billing Address:	[company billing address]
Primary Contact:	[name], [title], [email], [phone number]
Accounts Payable Contact (If different):	[name], [title], [email], [phone number]
Additional Contacts:	[name], [title], [email], [phone number]
Required for new and recertifications: The Submission Authorization Form signed by the applicant is attached. The filename is: [...]. Note: An updated Submission Authorization Form is required for recertification.

Product Information

[assessor notes]

Products Covered in this Application

Product or Product Group Name

Instructions: In the space below, provide the name of the product or product group submitted for certification. This product or product group name will appear on the certificate and the product registry.

Product or Product Group Name (for registry): [...]

Product Description for Assessment Use Only

Instructions: In the space below, provide a clear, but brief description of what the product or product group is, its function, and the different variations that are included in the group, if applicable (e.g. color, size, shape, material variations). This description is not for publication on the product registry. Rather, this is for C2CPII’s internal use only to better understand the product that was assessed.

Product or Product Group Description (for C2CPII internal use): [...]

Product Variations

Instructions: In the space below, provide the full name of all individually sold products covered by this report and any unique product identifiers (e.g,. UPC, EAN, GTIN, or SKU numbers) associated with these products. If possible, provide product names in the form of a comma-delimited list. These names will appear on the certificate and the product registry. It needs to be clear from this list exactly which products that can be individually purchased are covered by the certificate to be issued.

The certification scope must be made clear in situations where the product names do not sufficiently define what is and is not certified. For example, if only product variations sold in certain markets are covered by the assessment and there are products sold under the same name in other markets that were not assessed, this must be made clear (i.e., markets covered or excluded must be listed). If the products are modular in nature, describe which variant or variants were assessed and list any relevant exclusions.

If it is not possible to provide a list of individual products, describe the reason for this and propose an alternative way of uniquely identifying all products covered by this certification and delineating them from any products that are not covered. Also provide the total number of product variations in the table below. Attach a separate List of Certified Products if insufficient space is available to list these product variations directly on the certificate. Preferred: Use the Product Identifier Template.

A formatted List of Certified Products is attached. The filename is: [...].
List of ALL individual products included in the certification (please use a comma-delimited list): [product variation names and/or other identifiers]
The following are excluded from scope (e.g., by facility, region, product options, finishes, fragrance variations, etc.): [exclusions]
Number of product variations covered: [...]
The assessor has verified that the scope of certification as indicated by the product and product group names, the listed product variations, and the spec sheet (if provided) are accurate and unequivocally define the assessed product range. If the scope of certification is limited by facility, region, or otherwise, this information has been accurately noted in the fields above and/or in the spec sheet. The provided information is sufficient for a potential customer or third-party to clearly identify any products covered by this assessment and certification at the point of sale and distinguish them from any similar products that are not covered.

Conformance with Product Grouping Requirements

Check all that apply.

This application covers a single product.
This application covers multiple products or multiple product variations. The product group meets the following requirements in C2CPII’s product grouping policy (check all that apply):
Required. The products are in the same product category.
The products have a similar composition, OR
N/A (the product is modular). The product meets the modular product definition for the following reasons: [...]
Required. The products have the same manufacturing process.
Required. The products have the same function and have the same exposure scenarios.
Required. The product or products, including the number of product variations, are consistent with the standard’s definition of a product: “…any physical item that can be routinely and individually purchased from the applicant by other entities”

Product Registry Information: Description and Image

Please review the Product Registry Content Guidelines to confirm the product description and image meets these requirements. Images should be at least 700 pixels wide, 5MB or less, JPG or PNG. Limit is one image per product. If you would like to include multiple photos, please compile into one composite image file.

Please be sure that images accurately represent the product. Images that do not meet these requirements will not be posted on the product registry.

Check all that apply.

The applicant has recently completed the application form including product registry information.
The product description submitted as part of the certification application completely and accurately describes the product or product group that was assessed for certification and meets the Product Registry Content Guidelines.
The product image submitted as part of the certification application accurately depicts the product or product group that was assessed for certification and meets the Product Registry Content Guidelines.
For recertification: The current product registry entry and image (as already included on the product registry) are up-to-date and accurate.
Please use the following product description for inclusion on the product registry. Please note that C2CPII reserves the right to edit product descriptions that do not comply with the guidelines: [...]
Please use the attached image for inclusion on the product registry. The filename is: [...]
An image of the product or product group is not currently available and market ready. An image for the product registry will be reviewed and sent to C2CPII once finalized. Required: If a market ready image is not available, please submit an image for C2CPII’s internal use and provide the file name here: [...]

Product Category(ies) or Classification

Instructions: In the space below, classify this product into one or more categories from the list provided in Appendix 1 of the product grouping policy. Additionally, provide any industry-specific classifications that may be relevant (e.g.,. Construction Specifications Institute (CSI) MasterFormat Division for building products).

Product Category(ies): [...]

Packaging

Check all that apply.

N/A (no packaging included in certification scope)
The product is a liquid, gel, paste, or powder and is intended to be stored in its primary packaging during use or up until the moment of application (e.g., surface cleaner spray bottle, paint can, dishwasher powder box, nail polish bottle, wet-wipe pouch/packet/tub, hand soap bottle), or the product is dispensed from a paper core (e.g., tape, toilet paper). Furthermore, the product is not sold exclusively as material inputs for other products (i.e., it is not an intermediate product or raw material). In such cases, the primary packaging must meet the banned list requirements. Checking the next box is required.
Primary packaging, including inks, adhesives, and any materials used to label the package, meets banned list requirements. Signed declarations are attached. The filename(s) are: [...].
Required Packaging material has been defined as a biological or technical nutrient
Packaging material is a biological nutrient
Packaging material is a technical nutrient
Packaging was included in the assessment. It was included in the following way (check one):
Packaging was assessed as individual homogeneous material(s) within the multi-material product applying for certification. Assessment results for packaging are included with those for the primary product.
Packaging was assessed separately from the main product and received separate scores in the Material Health & Material Reutilization categories. The Packaging Form has been completed and is attached. The filename is: [...]
Instructions: If packaging was assessed, describe in the space below the nature of the packaging that was included and list all homogeneous materials by generic name or trade name that are part of the packaging.
Packaging Assessed: [...]
Instructions: If the packaging received a separate Material Health achievement level, select the recommended level. If the packaging did not receive a separate rating in this category, select ‘N/A’. Note that packaging materials may also be directly included in the material assessment of the product.
Material Health Level:

Certified Product Private Label Verification

Instructions: In the space below please provide a list of all private label products that are related to this certification. In addition, state whether they are in every way identical in production process and material composition to the certified product that is the subject of this ASF (the OEM Product). Otherwise, please provide BLDs for the private label packaging or provide reasoning for why packaging for the private labels is out of scope. These products will be permitted to receive Private Label certifications, based on the successful audit of this assessment, and subject to the Private Label Policy.

Product Name	Company	Identical Packaging Materials	BLDs Provided for Private Label Packaging	Packaging out of scope (identify reason)
No primary packaging	Intermediate Product	No exposure to packaging
[...]	[...]

Definitions of terms used in table above:

Identical Packaging Materials

The Private Label Product’s primary packaging uses the same materials (and no others) as the OEM Product’s primary packaging.

BLDs provided for Private Label Packaging

The Private Label Product’s primary packaging is different from the OEM Product’s packaging. Banned list declaration(s) have been provided for all homogeneous materials subject to review within the Private Label Product’s primary packaging including inks, adhesives, and any materials used to label the package.

Packaging Out of Scope

The product’s primary packaging is out of scope for the following reason and therefore banned list declarations are not required:

No primary packaging

The product is not contained within any primary packaging.

Intermediate Product

The product is sold exclusively as a material input for other products (rather than being sold to the general public).

No exposure to packaging

All packaging materials are intended to be removed prior to the product’s use (note: this does not include packaging intended to be kept with the product up until the moment of application; see primary packaging definition1).

Manufacturing Site(s)

[assessor notes]

Site Visit(s) – Optional for Material Health Certificates

Instructions: Briefly summarize information on the general nature of the site visit(s) (e.g., type of facility, total number of final manufacturing facilities for this product, total number of facilities visited) and what was achieved by the site visit(s). Also summarize key challenges and opportunities identified during each of the site visits. Note that a site visit is not required for Material Health Cerificates.

A site visit was not conducted.
A Site Visit Report is attached (optional). The filename is: [...].
Site Visit Summary: [...]

Final Manufacturing Stage of Product

Instructions: Pick the appropriate product category from the Guidance for Applying the Final Manufacturing Stage Requirements in the Cradle to Cradle Certified Product Standard, Versions 3.0 and 3.1. Then, check one below and provide the required information based on the selection.

A Process Flow Diagram is attached (optional). The filename is: [...].
Required: The product belongs to the following category from the Guidance:
If “Other,” please specify: [...]
The final manufacturing stage processes included in this assessment are the same as the processes for this product type that are listed in the Guidance.
The final manufacturing stage processes included in this assessment differ from those listed in the Guidance.
Additional processes: [...]
Processes from the guidance not included: [...]
Reason for adding or excluding processes with respect to the guidance: [...]

Final Manufacturing Stage Facilities

Instructions: Use the provided table to list all facilities where the product undergoes final manufacture and fill out the columns for facility location, processes conducted, and site visit date (for each facility where a site visit is required). If additional rows are necessary, attach an additional document.

Facility Name	Facility Location	Processes Conducted	Date of Site Visit (if applicable)
[...]	[...]	[...]	[...]
Individual(s) conducting site visit(s) (if applicable):	[Name, Title, Company/Assessment Body]

Material Health

Overview

Instructions: Summarize the Material Health assessment outcomes in the table below by adding a checkmark next to each of the requirements that has been fulfilled.

Level	Requirement
Basic	The product is 100% characterized by its generic materials (e.g., aluminum, polyethylene, steel, etc.) and/or product categories and names (e.g., coatings).
The appropriate metabolism (i.e., technical nutrient (TN) or biological nutrient (BN) is identified for the product and its materials and/or chemicals.
The product does not contain any Banned List chemicals based on supplier declarations.
Bronze	The product is at least 75% assessed (by weight) using ABC-X or abc-x ratings. Externally Managed Components (EMCs) are considered assessed and contribute to the overall percentage of the product that has been assessed. Complete formulation information collected for BN materials that are released directly into the biosphere as a part of their intended use (e.g., cosmetics, personal care, soaps, detergents, etc.).
A phase-out or optimization strategy has been developed for those materials with an X/x or GREY/grey rating (if applicable).
Silver	The product has been at least 95% assessed (by weight) using ABC-X ratings. Externally Managed Components (EMCs) are considered assessed and contribute to the overall percentage of the product that has been assessed. Complete formulation information has been collected for products that are entirely BN in nature (e.g., cosmetics, personal care, soaps, detergents, etc.).
The product contains no substances known or suspected to cause cancer, birth defects, genetic damage, or reproductive harm (CMRs) after the A, B, C, X assessment has been carried out.
Gold	The product has been 100% assessed (by weight) using ABC ratings. All EMCs are considered assessed as non-X.
The product contains no x-assessed or grey chemicals (optimization strategy is not required)
Product meets Cradle to Cradle emissions standards.
Platinum	All process chemicals have been assessed and none have been assessed as x or grey.
[assessor notes]

Product Metabolism (Basic)

Check one below.

Pure Biological Nutrient product
Pure Technical Nutrient product
Mixed (contains BN and TN materials, as denoted on the Bill of Materials)

Note: Biological Nutrient materials such as paper or bio-plastics may go through a series of technical cycles (e.g., recycling) before re-entering the biosphere (e.g., composting or incineration for energy recovery). They are still considered Biological Nutrients and are subject to the banned list requirements for Biological Nutrients.

Banned List Compliance (Basic)

All Materials

Required. No Banned List Chemicals are present above thresholds in any homogeneous materials subject to review in the product. This was determined as follows (check all that apply):
Banned list declarations have been obtained for any materials for which complete chemical composition information could not be obtained. These declarations were signed by (check all that apply and provide any additional required information based on the selection):
Suppliers.
The applicant. Explanation for how the applicant has sufficient knowledge regarding the chemical composition of covered materials to sign banned list declaration(s): [...]
The assessor. Explanation for how the assessor has sufficient knowledge to sign banned list declaration(s), given complete formulation information is not known: [...]
Analytical testing. Note: complete the appliable sections below for geological materials and/or recycled content.
Complete chemical composition information has been obtained for all materials not covered by banned list declarations and the Material Health assessor has confirmed that these materials meet the banned list requirements.
Banned list declarations are attached (optional). The filename is: [...].

Biological Nutrient Materials

Check the box if the following statement is true.

The product contains one or more Biological Nutrient materials. The biological material isn’t known to contain any toxic metals on the Biological Nutrient Banned List in the material above the allowable thresholds: Arsenic (10 ppm), chromium (100 ppm), mercury (1 ppm), cadmium (2 ppm), lead (90 ppm). Note: these are total concentration limits. Additional explanation (if needed): [...]

Geological Materials

Check the boxes if the following statements are true.

The product contains one or more geological materials. The geological material(s) have been tested as required per the Geological Materials Assessment Methodology. The following limits have been achieved: Arsenic (47 ppm), cadmium (17 ppm), chromium VI (0.2 ppm), lead (160 ppm), mercury (94 ppm). Note: these are leaching limits. Test report(s) are attached. The filename is: [...]. Additional explanation (if needed): [...]
Required for indoor use products containing bitumen, tar, and/or other complex/variable fossil-derived distillation residues. VOC emissions testing per standard section 3.9 has been conducted. Test reports are attached. The filename is: [...]. Note: this testing is required in all cases at the Basic level, although it may not be relevant to banned list compliance.

Recycled Content Materials

Check one below and complete any text fields required based on the selection.

The product contains no recycled content.
The product contains recycled content. All recycled content is banned list-compliant according to the biological nutrient or technical nutrient banned list and the Recycled Content Assessment Methodology (2017), or the Geological Materials Assessment Methodology (as relevant).
The following materials contain recycled content (list all recycled content materials or clearly label them in a separate bill of materials and reference the BoM here): [...]
Banned list compliance was determined in the following way(s). (check all that apply):
Metals: The material is fully defined based on the alloy grade specifications. No additional testing was required.
Glass and in some cases, other inorganic materials: The material is fully defined based on comprehensive elemental analysis. Detection limits are low enough to ensure banned list compliance. Test results are attached. The filename is [...]
Chemically recycled material (e.g., certain polymers): The chemical composition was controlled directly during the recycling process. No additional testing was required to determine banned list compliance.
Material type and explanation of the process including how chemical composition is controlled to ensure banned list compliance: [...]
Defined post-industrial recycled material (TYPE 1 & 2 including polymers, etc.): The material is from consistent and pure source(s). The manufacturer, trade name, and grade of material(s) are known. Banned list compliance has been determined based on banned list declarations and/or full material disclosure. No additional testing was required. (See the Recycled Content Materials Assessment Methodology (May 2017) for definitions of material Types 1-4.)
Material type, explanation of recycled content source (i.e., type of materials/products making up the recycling stream) and how banned list compliance is ensured: [...]
Defined post-consumer (TYPE 3) OR undefined mixed stream post-consumer (TYPE 4) recycled material: Analytical testing has been conducted per table 5 of the Standard. Sampling, analytical methods, and detection limits were appropriate for detecting banned substances at the required concentration thresholds. Test results are attached. The filename is: [...].
Testing was conducted for the following banned list substances that are common contaminants in this material and banned list limits have been achieved as listed below (see Table 5 in the standard for common contaminants). Note: Limits are total concentration limits, not leaching limits:
Required for all TN materials: mercury, chromium VI (1000 ppm each)
Required for all TNs without guaranteed management: cadmium (1000 ppm), lead (no limit for TNs but must be tested)
Required for all BN materials: arsenic (10 ppm), chromium (100 ppm), mercury (1 ppm), cadmium (2 ppm), lead (90 ppm)
Required for all polymers: banned organohalogens, including: [...]
Other as required per Table 5 [...]
Analytical testing of material has been conducted for the current certification period
The product contains recycled content that is Version 4.0 RSL-compliant per the Recycled Content Assessment Methodology (August 2020 or later), Restricted Substances List (March 2021), and Recycled Content Materials List of Analytes. The following materials were assessed per this methodology: [...] Note: It is optional to apply this methodology under Version 3.1. This is an alternative to applying the 2017 Recycled Content Assessment Methodology. The 2020 method may allow for ‘Type 4’ materials to achieve beyond the Bronze level.
Testing was conducted for the following restricted substances and limits achieved as follows. Test reports have been provided and the file name(s) are: [...]
Halogens (Br, Cl, F) do not exceed 1000 ppm each.
One or more halogen (Br, Cl, F) was present at > 1000 ppm. However, the exceedance was determined to be due to the following non-restricted substance(s). [...] This was determined as follows: [...]
Required for most products (those that are not in the categories listed below). Metals do not exceed the following limits: Total arsenic, chromium VI, lead, mercury (1000 ppm each); cadmium (100 ppm). Note: these are total concentration limits (not leaching limits). Limits apply to each metal and all of its compounds combined.
Required for brittle powder-like or pliable biological nutrient materials (e.g., paper). Metals do not exceed the following limits. Note: these are leaching limits. Limits apply to each metal and all of its compounds combined. If total concentration has been determined, the same limits may be applied.
Antimony: 45 ppm	Cobalt: 10.5 ppm
Arsenic: 3.8 ppm	Lead: 13.5 ppm
Cadmium: 1.3 ppm	Mercury: 7.5 ppm
Chromium III: 37.5 ppm	Nickel: 75 ppm
Chromium VI: 0.02 ppm	Selenium: 37.5 ppm
Required for liquid biological nutrient materials. Metals do not exceed the limits for liquid biological nutrient materials (refer to V4.0 RSL for limits)
Required for all other biological nutrient materials. Metals do not exceed the following limits. Note: these are leaching limits. Limits apply to each metal and all of its compounds combined. If total concentration has been determined, the same limits may be applied.
Antimony: 560 ppm	Cobalt: 130 ppm
Arsenic: 47 ppm	Lead: 160 ppm
Cadmium: 17 ppm	Mercury: 94 ppm
Chromium III: 460 ppm	Nickel: 930 ppm
Chromium VI: 0.2 ppm	Selenium: 460 ppm
Required for footwear, clothing or related accessories, and textiles which, under normal or reasonably foreseeable conditions of use, come into contact with human skin to an extent similar to clothing: Metals do not exceed the following limits: Total arsenic, cadmium, chromium VI, lead (1 ppm each after extraction); total mercury (1000 ppm).
Other applicable limits have been achieved as follows: [...] Note: refer to the RSL. Other limits apply to cement, leather, metallic jewelry, and metallic portions of apparel.

ABC-X Assessment Results (Bronze)

Percentage Assessed

Instructions: Enter the percentage assessed below.
Required. Percentage assessed for the product variation with the lowest percentage assessed (highest concentration of GREY materials) among all individual products in the group: [...]%
Check all that apply.
This is a single-homogeneous material product or a single-material product. The percentage assessed is based on the percentage of individually assessed chemical substances, rather than on the percentage of assessed homogeneous materials. Note: Single homogeneous materials with multiple color options are included in this category. Report percentage assessed based on the worst-case scenario (i.e., lowest percentage across all colors).
This is a multi-material product in which the percentage assessed is based on the percentage of the homogeneous materials in the finished product that received A, B, C, or X ratings, rather than the homogeneous inputs the applicant combines during the manufacturing process to form the homogeneous materials in the finished product.
This is a multi-material product in which the percentage assessed is based on the percentage of individually assessed chemical substances, rather than on the percentage of assessed homogeneous materials. The product contains at least one homogeneous material that makes up more than 25% of the finished product by weight and this material contains one or more GREY substances whose assessment is infeasible due to missing toxicity data or formulation information that the assessor is unable to obtain due to a supplier’s refusal to share the information. This homogeneous material is at least 95% assessed based on the weight fraction of the individual assessed chemical substances in the material. (Note: The bill of material must allow for checking of these percentages.)
Materials in the product are entirely BN in nature, entering the biosphere directly as part of their intended use (e.g., cosmetics, personal care, soaps, detergents, etc.). Complete formulation information has been collected for such materials, enabling the product to reach the Bronze level or above.
This product contains Externally Managed Components (EMCs). EMCs are counted as assessed and contribute to the overall percentage of the product that has been assessed. One EMC template has been completed and is attached for each EMC in this product. The filenames are: [...].

Assessment Table

Check all that apply. If more than one product is in scope for a single certification or MHC, a bill of materials that allows for checking that the product grouping rules have been met must be provided. In this case, using the table in the ASF (section 5.4.2) to report assessment ratings may not be sufficient.

In the Material/Substance Name column (either in the table below or in the attached assessment results as applicable), indicate the chemical’s name, specific function type (e.g., solvent, surfactant, chelating agent, plasticizer, UV stabilizer, filler) and/or class (e.g., acid, base, phthalate, organohalogen, silicone compound, bitumen).

In the Assessment Comments column (either in the table below or in the attached assessment results as applicable) note the following:

Key consideration(s) and reasoning that lead to each assessment rating, such as the H-phrases that were the determining factor(s) for assigning a specific rating.

Which specialized methodologies, other than the general Material Health Assessment Methodology where used, if any.

Whether the assessed substance is a CMR or PBT or whether the assessed material contains CMRs or PBTs.

For Silver level applications, how the absence of CMRs was verified.

Relevant case-specific information regarding the identity/type/function of chemicals/materials assessed (for example if the substance or material belongs to a chemical class of relevance for Material Health assessment).

Exposure considerations, if applicable.

Any atypical situations that would warrant further scrutiny/discussion, if any.

Assessment results have been provided by the Material Health Assessor. These are:
Included in a separate document. The filename is: [...].
Included in the summary table below.
The Updates to the Material Health Assessment Methodology (2020) have been employed (required for applications received on or after January 1, 2022 for Version 3.1 applications).
Assessment ratings on a homogeneous material basis are shown (ABC-X).
Required. All homogeneous materials as present in the finished product are represented by an ABC-X or Grey rating. If a homogeneous material occurs in a number of distinct variations in the finished product, it may be further subdivided to break out material components that vary (such as colorants) from the base material that remains the same. Such material components may receive separate ABC-X ratings if they are mixtures or separate abc-x ratings if they are individual chemicals, however, the top-level homogeneous materials present in the finished product must be used to calculate the percentage assessed.
Assessment ratings on a chemical substance basis are shown (abc-x).
Required. These correspond to chemical substances that are present as such in the finished product (i.e., not process chemicals which react to form unlisted chemicals or mixtures in the finished product).
This is a single homogeneous material product.
Required. Assessment results are not reported as a single ABC-X rating. Instead, an assessment rating for each chemical or formulation as used or purchased by the manufacturer is provided; these may have abc-x or ABC-X assessments depending on whether they are single chemicals or mixtures.
Required. The applicant is applying for an MHC and meets all the following requirements for reporting assessment data:
The information provided in the bill of materials is in agreement with the total number of substances data provided in the MHC form.
If the product is a single homogeneous material product and any ABC-X assessment are reported for input formulations/mixtures, the number of chemicals within the input formulation are included in the MHC table.

Material/substance name (can be generic name or role)	MH Assessor ID	ABC-X / abc-x Rating	Assessment Comments
[...]	[...]	[...]	[...]

Polymers (if assessed)

Instructions: Complete this section if the product contains any polymers that are assessed.

Monomers have been evaluated when present at ≥ 1000 ppm per polymeric material (or ≥ 100 ppm for formaldehyde). Note: The subject to review limit for monomers is 1000 ppm per homogeneous material under Version 3.1. When applying under Version 3.1, an exposure assessment for monomers that are present above the subject to review limit may only be conducted for the inhalation route. Otherwise, plausible exposure must be assumed for any residual monomers present at a concentration of ≥ 1000 ppm (or ≥ 100 ppm for formaldehyde).
Monomers have been evaluated when present at 100 ppm or above per polymeric material. Note: This limit may optionally be applied under Version 3.1 and is required under Version 4.0. However, if applying under Version 3.1 in Material Health, the limitation on conducting an exposure assessment noted in the line above still applies.

Biological Materials (if assessed)

Instructions: Complete this section if the product contains any biological materials that are assessed. Materials must have been assessed per the most recent version of the Biological Materials Assessment Methodology.

The product contains the following tree-based materials: [...]
All stains, treatments and other coatings on the material have been identified in terms of their constituent chemicals, and assessed according to the Material Health Assessment Methodology.
The tree-based material is from a species that is known to have sensitizing effects (e.g., certain species of blackwood or rosewood).
Other hazards and/or additional explanation: [...]
Required unless the material is X-assessed or grey: The potential for wood dust exposure during the product’s final manufacture, installation, intended and likely unintended use and end-of use scenarios has been evaluated and included in the exposure assessment.
The product contains plant-based fibers, other plant based materials, or animal-based fibers.
Dyes, auxiliaries, bleaching agents, treatments or other chemical additives present above subject to review limits have been assessed according to the conventional Material Health Assessment Methodology or Colorants Assessment Methodology (as relevant). Note: If some are x-assessed the material will be X-assessed overall. If some are grey and there are no X-assessed substances, the material will be grey overall. Otherwise, the overall rating for the material will depend on the methods and results per the lines below. Note that bleaching chemistry is subject to review at any level.
Plant and/or animal-based fibers are Global Organic Textile Standard (GOTS) certified or equivalent. Note: This allows for a B-assessment if all other substances subject to review have been a- or b-assessed. Fiber type(s): [...] GOTS or equivalent certificate file name: [...] Test results file name (required unless the material is GOTS certified): [...]
Plant-based materials are Öeko-tex 100 certified (not applicable to animal fibers) Material type(s): [...] Certificate file name: [...] Test results file name: [...]
Total pesticides in the material are < 0.5 ppm. Note: This allows for a C-assessment if all dyes and other additives have been a, b, or c assessed.
Total pesticides are > 0.5 ppm and the material is X-assessed.
Plant and/or animal-based material(s) do not have GOTS or equivalent certification and/or were not grown according to organic farming practices (or are not Öeko-tex 100 certified for plant-based material). Check all that apply below.
The source of the material has been determined, and a list of pesticides used has been obtained. The active ingredient(s) in the pesticide mixture(s) have been assessed according to the conventional Material Health Assessment Methodology. The raw fiber has been tested for any x and grey assessed pesticides. Fiber type(s): [...] Test results file name: [...]
Plant-based: The source of the material has not been determined. The raw fiber has been tested for the list of pesticides as required by the most recent version of the EU Ecolabel for Textile Products. Fiber type(s): [...] Test results file name: [...]
Animal-based: The source of the material has not been determined. The raw fiber has been tested for the list of pesticides as required per the Biological Materials Assessment Methodology. Fiber type(s): [...] Test results file name: [...]
Detection limits for pesticides listed by GOTS or the EU Ecolabel are < 0.1 ppm.
Testing has been conducted by an ISO 17025 accredited laboratory.
Material(s) contain x-assessed pesticides. The sum concentration of all x-assessed pesticides per material is/are: [...] Note: if the total is > 0.5 ppm (or if individual substances exceed the specified limits per the Biological Materials Assessment Methodology or EU Ecolabel as applicable) the material must be X-assessed.
Material(s) contain grey pesticides. The sum concentration of all grey assessed pesticides per material is/are: [...] Note: if > 0.5 ppm the material must be grey assessed (unless it is X for other reasons).
Other methods have been employed in assessing plant-based or animal-based materials as permitted per the Biological Materials Assessment Methodology as follows: [...]
The product contains other biological materials (beyond those listed above). These have been assessed as follows: [...]

Material Health Certificate Table

Instructions: Complete the appropriate table below, depending on whether this application pertains to a multi-material product, a multi-material product with uncountable color variations, a single-homogeneous material product, or a single-material product. Check all of the boxes that apply underneath the relevant table. For assistance selecting the correct table, please see descriptions of each case below.

Multi-Material Product

Most products containing more than one homogeneous material fall into this case.

Multi-Material Product with Uncountable Color Variations

This classification applies to multi-material products with one or more materials that come in color variations that are customizable or otherwise too numerous to count. Since each color variation would ordinarily be counted as a unique homogeneous material (since it has a unique composition), counting the number of homogeneous materials is not practical for products of this type. Accordingly, the table requests the number of chemical substances instead.

Single-Homogeneous Material Product

This classification applies to products that are a single homogeneous material (e.g. shampoo).

Single-Material Product OR Multi-Material Product exception

This classification applies to:

Products that are 95% or more a single homogeneous material, but that also contain one or more coatings or similar layers.

Multi-material products that contain at least one homogeneous material that makes up more than 25% of the product by weight and that contains one or more GREY substances whose assessment is infeasible due to missing toxicity data or formulation information that the assessor is unable to obtain due to a supplier’s refusal to share the information. The homogeneous material must also be at least 95% assessed based on the weight fraction of the individual assessed chemical substances in the material.

See the standard and Supplemental Guidance for the complete definition of a single-material product. The standard explains that the percentage assessed may be calculated on a chemical substance basis for single-material products, so the table requests the percentage-based metrics for such products at the chemical substance level. Because these products actually contain more than one homogeneous material, it is also fine to treat them as multi-material products.

Note: The ‘Minimum %’ and ‘Maximum %’ fields are included in the tables in order to accurately capture assessment results for assessments that cover more than one product variation. All products in the group must contain materials that fall within the percent ranges stated.

Multi-Material Product
A/B	C	X	GREY
Minimum %	[...]	[...]	[...]	[...]
Maximum %	[...]	[...]	[...]	[...]
Total Number of Materials	[...]	[...]	[...]	[...]
Instructions: Indicate whether the following statements are true (by checking the box), based on the numbers provided in the table.
Required. The numbers in the “Total Number of Materials” row reflect the number of homogeneous materials with each assessment rating in the product group, rather than in any individual product variation.
Required. The numbers in the “Total Number of Materials” row reflect the number of unique homogeneous materials in finished products in the group, rather than the number of ingredients the applicant combines during the manufacturing process.
The product contains materials that come in multiple color variations. Each color variation has been counted as a unique homogeneous material, because it has a unique formulation.

Multi-Material Product with Uncountable Color Variations
A/B	C	X	GREY
Minimum %	[...]	[...]	[...]	[...]
Maximum %	[...]	[...]	[...]	[...]
a/b	c	x	GREY
Total Number of Chemical Substances	[...]	[...]	[...]	[...]
Instructions: Indicate whether the following statements are true (by checking the box), based on the numbers provided in the table.
Required. The product contains materials that come in color variations that are customizable or otherwise too numerous to count. Since each color variation would ordinarily be counted as a unique homogeneous material, counting the number of homogeneous materials was not practical for this product group. Accordingly, the total number of chemical substances in the product group has been reported instead of the total number of materials. The maximum and minimum percentages were still computed at the homogeneous material level.
Required. The numbers in the “Total Number of Chemical Substances” row refer to the number of chemical substances with each single chemical risk rating in the product group, rather than in any individual product variation.
Required. The numbers in the “Total Number of Chemical Substances” row reflect the number of unique chemical substances (with CASRN) in finished products in the group (including all chemicals subject to review that may not be present in final product), rather than the number of ingredients the applicant combines during the manufacturing process.

Single-Homogeneous Material Product
a/b	c	x	GREY
Minimum %	[...]	[...]	[...]	[...]
Maximum %	[...]	[...]	[...]	[...]
Total Number of Chemical Substances	[...]	[...]	[...]	[...]
Instructions: Indicate whether the following statements are true (by checking the box), based on the numbers provided in the table.
Required. The numbers in the “Total Number of Chemical Substances” row refer to the number of chemical substances with each single chemical risk rating in the product group, rather than in any individual product variation.
Required. The numbers in the “Total Number of Chemical Substances” row reflect the number of unique chemical substances (with CASRN) in finished products in the group (including all chemicals subject to review that may not be present in final product), rather than the number of ingredients the applicant combines during the manufacturing process.

Single-Material Product, OR
Multi-Material Product exception
a/b	c	x	GREY
Minimum %	[...]	[...]	[...]	[...]
Maximum %	[...]	[...]	[...]	[...]
A/B	C	X	GREY
Total Number of Materials	[...]	[...]	[...]	[...]
Instructions: Indicate whether the following statements are true (by checking the box), based on the numbers provided in the table.
Required. The product meets the definition of a single-material product or the requirements for the multi-material product exception. Accordingly, the minimum and maximum percentages have been reported at the chemical substance level. The total number of materials was still computed at the homogeneous material level
Required. The numbers in the “Total Number of Materials” row reflect the number of homogeneous materials with each assessment rating in the product group, rather than in any individual product variation.
Required. The numbers in the “Total Number of Materials” row reflect the number of unique homogeneous materials in finished products in the group, rather than the number of ingredients the applicant combines during the manufacturing process
The product contains materials that come in multiple color variations. Each color variation has been counted as a unique homogeneous material, because it has a unique formulation.

Hazard and Risk Assessment Considerations (Bronze)

Instructions: Indicate the phases and processes considered in the chemical toxicity assessment (previously referred to as ‘assessed applications’) below. If a Material Health Certificate is requested, this list will be printed on the Material Health Certificate. These are the final manufacturing, use, and end-of-use phases and processes that were considered during the hazard and exposure assessment, and they indicate to the Material Health Certificate reader under which circumstances the assessment ratings are valid.

Phases and Processes Considered in the Assessment

Manufacturing (i.e., for intermediate products). Optional: List processes (per the Final Manufacturing Stage Methodology): [...]
Final manufacturing. Optional: List processes [...]
Professional use (i.e., use during subsequent manufacturing steps for intermediate products or use by a professional during installation/application)
Use (i.e., as end product). Optional: specify use(s): [...]
Intended end-of use processes:
Recycling
Composting (Note: Please do not select composting unless compost testing has been conducted)
Release to the environment (e.g., via wastewater treatment for cleaners and personal care)
Other: [...]
Unintended end-of use processes:
Landfilling
Incineration
Uncontrolled burning
Release to the environment
Other: [...]
Additional comments regarding assessed phases and processes: [...]

Check the box if the following statement is true.

Required. The end-of-use scenarios listed above include the intended and likely unintended end-of-use scenarios for this product, defined as the end-of-use fate of 80% or more of the products sold by the applicant.

If any common end-of-use fates have been excluded (landfilling, incineration, uncontrolled burning, etc.), explain in the space below how it was determined that the remaining end-of-use scenarios cover 80% or more of products sold.

[...]

Exposure Routes

Check all that apply.

The single chemical risk ratings of all substances subject to review in all assessed materials in this product were based solely on the unmodified hazard ratings (i.e., exposure did not play a decisive factor in the material health assessment for this product).
For one or more substances subject to review in assessed materials, exposure relevant to an identified RED or GREY hazard was deemed non-plausible or negligible, leading to a YELLOW risk rating. This was the case for the following estimated number of materials: [...] The reasons why exposure was deemed non-plausible or negligible are noted:
In the assessment table or in the attached assessment results as noted in section 5.4.2 above.
In the table below. (Note: this option is preferred when applicable to ≤ 5 substances or materials.)
The assessment results are valid only when administrative or engineering controls and/or personal protective equipment (PPE) are properly used at final manufactuing stage facilites.
The assessor has reviewed documented enviornmental, health and safety processes and proceedures used at the the relevant facilitites as verification that the proper controls and/or PPE are in use.
The assessor has verifyed that proper controls and/or PPE are in use at a manufactuing site visit (note: a site visit is not requried for Material Health certificates).

Stage	Oral	Dermal	Inhalation	Aquatic	Other Environmental Release
Final Manufacturing stage	[...]	[...]	[...]	[...]	[...]
Professional use (subsequent manufacturing)	[...]	[...]	[...]	[...]	[...]
Professional use (installation etc.)	[...]	[...]	[...]	[...]	[...]
Use phase	[...]	[...]	[...]	[...]	[...]
End-of-use	[...]	[...]	[...]	[...]	[...]
This is an intermediate product (e.g. polymer resin) or other professional use product (e.g. professional grade paint) sold only to professional users. The assessment results are valid becuase all professional users have been trained in the proper handling of the product and use of protective equipment for sensitizing and/or corrosive or irritating substances. The assessor has verified that professional customers are adequately informed of these issues and that adequate training has been provided as required per Appendix 2 of the Exposure Assessment Methodology. Note: this approach is only allowed for the sensitization and corrosion/irritation endpoints. The following disclaimer should be included on the certificate: [...] Documentation required for verification per Appendix 2 has been provided. The filename(s) are: [...]
This is an intermediate product (e.g. polymer resin) or other professional use product (e.g. professional grade paint) sold only to professional users. The assessment results are valid only when the product is transported and used with fully closed and sealed transport, transfer, and dosing systems (as relevant) to protect workers and/or the environment during subsequent manfuactuing or other professional use only application steps from RED or GREY hazards. The assessor has verified that all professional users are using closed systems as required per Appendix 2 of the Exposure Assessment Methodology. The following disclaimer should be included on the certificate: [...] Documentation required for verification per Appendix 2 has been provided. The filename(s) are: [...]

Determining Absence of CMR Substances (Silver)

Required: The product is ≥ 95% assessed and assessed materials do not contain known or suspected CMRs for which exposure is likely or significant.
Required if materials counting as assessed contain GREY substances: The material supplier or other party with knowledge of the chemical composition of the material has signed a declaration stating that CMRs are not present in the material. Note: This also applies to materials for which percentage assessed has been calculated based on the percentage of individually assessed chemicals by weight. For example, this means that if the certified product is a homogeneous material, CMR declaration(s) are required for any unidentified portions of the material when applying at Silver level.

Geological Materials (Silver)

Required for indoor use products that contain rock or stone-based material (e.g., granite) or industrial by-products defined as geological materials (e.g., coal fly ash, phosphogypsum, blast furnace slag). Material(s) have been evaluated for the presence of radium, thorium, and potassium 40 (K40). Material type(s): [...] The activity concentration index (I) is: [...] Test results file name: [...] Literature review file name (if relevant): [...]
Required for materials that contain bitumen, tar, and/or other complex/variable fossil-derived distillation residues. Material(s) have been tested for the polycyclic aromatic hydrocarbons (PAHs) covered by REACH Annex XVII Article 50 at a minimum. The sum concentration of tested PAHs is < 100 ppm.
Required for indoor use products containing bitumen, tar, and/or other complex/variable fossil-derived distillation residues. The product has undergone VOC emissions testing per standard section 3.9. CMR substances have not been emitted above the detection limit, or detected CMRs are below (0.01) x [the lower of the TLV or MAK value].

Recycled Content (Silver)

The assessed portion of the product contains TYPE 3 recycled content material assessed per the Recycled Content Material Assessment Methodology (2017) Note: Type 4 recycled content materials are not eligible at the Silver level. See the Recycled Content Material Assessment Methodology (2017) for definitions of material Types 1-4. The material type(s) assessed via this method are: [...]
Required. Segregation of materials has limited the scope of material to a very consistent and narrow group of inputs of a single material type and variation. Provide an explanation for how material(s) meet this definition: [...]
Required. There is a high sophistication of collection, separation, identification, and cleaning technologies for the material such that the recycler is able to guarantee that the input material will always be the same. Provide an explanation for how the input stream is highly consistent, how there is extremely low variation in chemical content from batch to batch, and how the analytical testing regimen used ensures that problematic chemicals are consistently captured and determined to be present below 100 ppm: [...]
Required. Provide an explanation for how the presence of CMRs above the allowable limits can be ruled out. Provide test data if applicable. Note: CMR declarations alone are not sufficient for this material type. [...]
Required for a C-assessment of Type 3 material. Analytical testing of material has and will be conducted every 6 months.
The assessed portion of the product contains recycled content material(s) assessed for the Silver level and above based on analytical testing per the most recent version of the Recycled Content Assessment Methodology and Recycled Content Materials List of Analytes. Note: this is optional under v3.1. The material type(s) assessed via this method are: [...] The filtered List of Analytes (showing the relevant analytes and limits for these materials) and analytical test report files are provided. The file names are: [...] Additional comments (if needed): [...]
Check all that apply below:
One or more substance(s) included in the List of Analytes for the applicable material type(s) was/were not tested for. The substances and rationale(s) for removing these from the ‘worst case’ list(s) are as follows: [...]
All Silver level limits have been achieved for the substances included in the analysis. An exposure assessment was not required.
One or more substance(s) was/were determined to be below the RSL limits but above the Silver level limits per testing conducted. The material(s) may be used at the Silver level and above based on the exposure assessment. Provide explanation: [...]
All halogens were included in a total halogen screening test (Cl, Br, F, I). Limits achieved are as follows: [...] Note: Halogenated organic substances based on iodine are not on the RSL. Iodine must be tested for to confirm compliance with the organohalogen restriction at the Silver level (1% per homogeneous material) and Gold level (100 ppm per homogeneous material or less for specific substances if the RSL limit is lower or the Specific Concentration Limit (SCL) is lower). Iodine does not have to be tested for at Bronze level. Cl, Br, and F must be tested for to confirm compliance with the organohalogen restrictions at Bronze, Silver, and Gold. This screening test may also be employed to ensure that the Silver level limits are achieved for all organohalogens on the RSL and organohalogens that are SVHCs. Refer to the List of Analytes for additional information.
In the case that any halogen was determined to be below 100 ppm but above one or more of the RSL limits per the total halogen screen, signed RSL attestations were obtained from the applicable supplier or other entity with knowledge of material composition (refer to the List of Analytes for the substances for which this is allowable). [...]
The applicant is aware that if employing this methodology and applying for Silver level and above, quarterly testing is required in the first two years (i.e., until recertification). Test results must be provided to the assessor. If exceedances are identified, C2CPII must be notified. If no issues are identified, testing may then be conducted once every two years (i.e., prior to each subsequent recertification).

Volatile Organic Compound (VOC) Emissions Testing (Gold)

Check one below and provide any additional required information based on the selection.

VOC emissions testing is not required for this type of product, because the product is a (select one):
VOC emissions testing is required for this product, because it is permanently installed in indoor rooms, used to permanently install indoor products (e.g., adhesive, sealant), permanently applied to surfaces in indoor rooms, or used as permanent or long-term equipment of indoor rooms (e.g., furniture). The product meets the Cradle to Cradle Certified VOC emission standards as specified in Section 3.9 of the standard and guidance. Test results have been evaluated and are attached. The VOC emissions testing form has been completed and is also attached. The filenames are: [...]

Process Chemicals Assessed and not x-Assessed (Platinum)

Check one below.

The final manufacturing stage involves no process chemicals as per the definition in the v3.1 Standard.
The final manufacturing stage involves no process chemicals aside from those already included in the product assessment and the materials and chemical substances included in the product assessment are all assessed A/a, B/b, or C/c.
The final manufacturing stage involves process chemicals and all have been identified and assessed. None are x-assessed.
The list of process chemicals and their assessment ratings can be found (select one):
[...]

Material Optimization Strategy (Bronze)

Check one below and provide any additional required information based on the selection.

The product does not contain X/x and/or GREY materials/chemicals; a material optimization strategy is not required.
The product contains X/x and/or GREY materials/chemicals; a strategy is required. Check one below and fill in the relevant table based on the selection.
This application pertains to a new certification. An optimization strategy is summarized in the table below.
Note: A longer strategy may optionally be attached, but the summary in the table is mandatory. If additional rows are necessary, attach an additional document and note filename here: [...]
Material or Chemical Substance	Planned Optimization Actions	Approx. Timeframe
[...]	[...]	[...]
This application pertains to a recertification. Tangible steps toward optimization (e.g., conducting trials with new materials, contacting suppliers to learn about alternatives, replacing a problematic material, obtaining formulation information or completing an assessment for a previously GREY material) have been taken in the last certification period and are summarized in the table below. If the alternative compliance pathway (i.e., company-level progress) is being followed, the same table is to be used but the product(s) for which progress has been made should be specified in the first column in addition to the materials or chemical substances.
Note: Additional information may optionally be attached, but the summary in the table is mandatory. If additional rows are necessary, attach an additional document and note filename here: [...]
Material or Chemical Substance	Actions Taken toward Assessment or Optimization	Month and Year in which Action(s) Occurred
[...]	[...]	[...]

Primary packaging refers to the container that envelops a liquid, gel, paste, or powder and is intended to be kept with the product during its use or up until the moment of application (e.g., surface cleaner spray bottle, paint can, dishwasher powder box, etc.). Any materials that are intended to be removed prior to the product’s use are not considered primary packaging (e.g., pallet, shrink wrap, carton).