APPLICATION FOR PRODUCT EVALUATION 03390 (2022 Standard)

您的浏览器中未启用 JavaScript，因此无法打开此文件。请启用 JavaScript，然后重新加载。

INSTRUCTIONS TO APPLICANT:
Answer all questions. If a question is not applicable, enter “N/A”
Product has to be re-evaluated every 5 years
UDOT will notify the applicant about the evaluation decision within 45 days after all the required documents and data are received.

Check the boxes below for the documents which are attached in your application: Please email all documents to udotapl@utah.gov *

Installation instructions

Independent laboratory testing results(Testing Results dated over 5 years from this submittal date are not accepted)

Materials safety data sheets

Limitations for use and or maintenance of the product

Manufacturers Product Data Sheet

必填

1. Product Name *

2. Product Description *

3. Manufacturer Company Name *

4. Manufacturer Contact Name *

5. Manufacturer Address *

6. Manufacturer Phone # *

7. Manufacturer Email *

8. Manufacturer Website *

9. Distributor Company Name *

10. Distributor Address

11. Distributor Contact

12. Distributor Contact Phone #

13. Distributor Contact Email

14. Distributor Website

15. Has the product previously been submitted to UDOT for evaluation? *

Yes

清除表单内容

切勿通过 Google 表单提交密码。

此表单是在 State of Utah 内部创建的。举报滥用行为

表单