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1.1. CLIENT INFORMATION

Responsible*
First name: Last name: Phone: Mobile: Email:

Representative
First name: Last name: Phone: Mobile: Email:

1.2. ESTIMATED TESTS START DATES

EMC: Radio:
Product Safety: Environmental:
Telecom:

1.3. DESCRIPTION OF EQUIPMENT UNDER TEST

Short Description*:
Manufacturer*: Test item(s)*:
Model*: Trademark:
EUT condition: EUT Classification:
Software release: Hardware version:
Serial number: Operational location:
Dimensions (mm):
Height
Width
Depth
Weight (kg):

2.2. EUT OPERATING MODES (explanation)

# Operating mode description Configuration
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2.3. POWER SUPPLY

Power Supply type Min Rated Max
Voltage (V)

Current (A) / Power (W)

Frequency (Hz)








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2.4. PORTS AND LINES (explanation)

Port type Port description Connected Quantity Cable type Cable length, m Location
From To
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3.1. Operating frequencies (explanation)

Source Frequency, MHz
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3.2. EMC MODULES AND SUB-ASSEMBLIES (explanation)

Description Manufacturer Model or P/N Hardware rev. Serial number Slot
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3.3. SUPPORT AND AUXILIARY EQUIPMENT (explanation)

Description Manufacturer Model number Serial number
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3.4. PERFORMANCE/ACCEPTANCE CRITERIA / Essential Performance (EMC Immunity tests) (explanation)

3.5. TEST CONFIGURATION (explanation)

Note: An input/output unit of a system that feeds data into and/or receives data from the central processing unit of a personal computer, connected either internal or external and intended for use within residential environment (class B), deems personal computer peripheral device and must be tested in minimum configuration consisting of the EUT, personal computer, keyboard, mouse, monitor, serial and parallel port terminations and relevant terminations/ simulators for other PC ports, all the mentioned devices must be placed within a test site.

(file up to 5 MB)

The following documentation is to be provided prior to safety investigation initiation

Document Remarks
Factory details Name and address of all manufacturing locations, contact details
Installation and operating instructions Instructions shall specify temperature range, supply voltages, indoor or outdoor installation, IP rating (if applicable), special safety requirements, etc.
Schematics and block diagram Block diagram (for complicated systems), schematics of safety critical parts (AC power distribution, ac/dc and dc/dc power supplies, battery charge and protection circuits, TNV circuits, SELV interfaces showing power limiting components)
Parts list/ Bill of materials Safety critical components should be identified on that list. For these components, the list should include rating, manufacturer, model number and UL/CSA/other file number, where applicable.
Data sheets for safety critical components Examples of safety critical components: appliance inlet, batteries, circuit breaker, fuse holder, fan, indicator, interlock, laser, mains connector, motor, motor capacitor, main switch, optocoupler, overvoltage protector, plugs/terminals, power supply, power cord (set), fuse, PCB material, plastic covers, plastic large components, RFI capacitor/choke/filter, safety interlock, solid state relay, thermal protector, terminal block, transformer, voltage selector, power wires, etc (other components will be decided on case-to-case basis), motherboard, monitor, external connectors.
Rating/marking plate/label example
Mechanical drawings/equivalent specifications Only when required for the project. Information should be provided about: dimensions, vents size and location, fans size and location. Rack mechanical drawings are required.
PCB layouts of all layers Only when required for the project.
Description of all hazard sources other than electrical Only when required for the project. Including but not limited to mechanical hazard, laser, light, UV, acoustic noise and the like
Risk analysis, software validation, biocompatibility, sterilization Only when required for the project. Always required for medical devices.
System in a full load mode
Fuses rating and fans speed information

Telecom investigation

1. Type of equipment

  • Terminal equipment
    • Phones
    • Data and fax modems
    • xDSL modems
    • Telephone dialers
    • Other
  • Gateway
  • PBX (Private Branch Exchange)
  • CO (Central Office Equipment)
  • Other

2. Wire interfaces

  • Analog two-wire (POTS) e.g. terminal equipment, central office equipment
  • E1/T1 Unframed, Framed, ISDN PRI
  • E3/T3
  • 10/100/1000 Base-T ethernet
  • Other

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