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

Billing and Contact Information – (the report will be sent to this address)
Name      
Company      
Address      
City, State/Province Zip      ,            
Country      
Phone       E-mail      

Report Contact information as you want it to appear on the final report (if different than above)
Name      
Company      
Address      
City, State/Province Zip      ,            
Country      
Phone       E-mail      
Test to be conducted:
Fabric Testing* Other Testing*
Full ASTM F1506 ASTM F887 (Fall Protection Harness)

ASTM F1959 Textiles (per F1506) ASTM F2621 (Garment Evaluation)

ASTM F1959 Rainwear/laminates (per F1891) IEC 61482-1-1 Method B(Garment Evaluation)

IEC 61482-1-1 Method A ASTM F2675 Glove Test

Scouting (requires 3 panels per shot ) ASTM F2676 Blanket Test

      # of Shots
Scouting (Mannequin tests include 2 shirts per
      Rating trying to achieve shot)

Other (for partial testing to ASTM F1506, please       # of Shots

indicate the tests you require in special instructions below).
      Rating trying to achieve
Special Instructions:      
Your test reference number (optional):      

Part A – For Fabric Panels, Garments, Balaclavas, Gloves

ArcWear to launder? Yes No 0 wash
Laundry Method: 3 wash / 1 dry (for ASTM F1959 and F2621)
AATCC Method 135 (for ASTM) 5 wash / 1 dry (For IEC 61482)
ISO 6330 (for IEC) Other      
ArcWear to cut panels? Yes No (Fabric testing only)
Fabric Description:
Layer 1: (Top Layer) Color:      
Manufacturer:       Style No.      
Nominal Weight:       oz/yd2 or       g/m2 Dye Type (i.e. vat, solution, reactive):      
Fabric Type: Woven Type: (i.e. plain weave, twill…):      
Knit (i.e. jersey, mesh…):      
Non-Woven (i.e. spunlace, felt…):      
Fiber Content and Percentage of Each Fiber:      

Revised 09-30-14 SLK

 If multi-layered system, please complete next page.
Additional fees for ratings >25 cal/cm² and laminated fabrics requiring ASTM F1891 testing.
Fabric Description:
Layer 2: (Second Layer) Color:      
Manufacturer:       Style No.      
Nominal Weight:       oz/yd2 or       g/m2 Dye Type (i.e. vat, solution, reactive):      
Fabric Type: Woven Type: (i.e. plain weave, twill…):      
Knit (i.e. jersey, mesh…):      
Non-Woven (i.e. spunlace, felt…):      
Fiber Content and Percentage of Each Fiber:      
Fabric Description:
Layer 3: (Third Layer) Color:      
Manufacturer:       Style No.      
Nominal Weight:       oz/yd2 or       g/m2 Dye Type (i.e. vat, solution, reactive):      
Fabric Type: Woven Type: (i.e. plain weave, twill…):      
Knit (i.e. jersey, mesh…):      
Non-Woven (i.e. spunlace, felt…):      
Fiber Content and Percentage of Each Fiber:      
Fabric Description:
Layer 4: (Fourth Layer)
Manufacturer:      
Nominal Weight:       oz/yd2 or       g/m2
Fabric Type: Woven Type: (i.e. plain weave, twill…):      
Knit (i.e. jersey, mesh…):      
Non-Woven (i.e. spunlace, felt…):      
Fiber Content and Percentage of Each Fiber:      
Part B – Other Testing (do not fill out for fabric panel testing)
Describe each item to be tested, including type of item, style or identification number, and any information
to be included in the report.
Fabric information should be filled in under Part A for garments, balaclavas, hoods, and gloves.
Fall Protection: Also, webbing material and color, accessories attached to base model (if any)
1. Style/Model Number      
Description:      
For garments: Fabric Rating       Test Report Number:      

2. Style/Model Number      

Description:      
For garments: Fabric Rating       Test Report Number:      

3. Style/Model Number      

Description:      
For garments: Fabric Rating       Test Report Number:      

4. Style/Model Number      

Description:      
For garments: Fabric Rating       Test Report Number:      

*Arc tests are subcontracted

Test Reports will be sent by email and stored in your account at www.arcwearonline.com. To have a
paper copy sent to you at an additional fee: N umber of Copies:       ($50 for each copy)

Revised 09-30-14 SLK