電気用品安全法特定電気用品 適合性検査申込みのご案内
Contents
1. 19 42 1 1 PCM 71 00 01 TL Ed 3 6 0 2 AAA NC Application for Conformity Assessment Date Project No JET2. 11 12 J ET
3. J ET J ET 1
4. J ET J ET 1 TEL FAX E mail 2
5. 0 5 500 0 5
6. 2 2 2 1 2
7. PSE RE 701 PSE i 202 PSE RE 703 PSE RE 203 PSE RE 204 1 CB CB 4
8. 2 3 39 42 PCM 71 00 01 TL Ed 3 6 3 1 2 2 40 42 PCM 71 00 01 TL Ed 3 6 4
9. J ET JE 1 TEL FAX E mail 2 TEL FAX E mail 17 42 2 6 PSE RE 305
10. 7 JE i 8 9 21 42 PCM 71 00 01 TL Ed 3 6 PSE RE 402 _ JET
11. 500 1 1 5 2 2 0 5 0 5 0 5 0 5
12. J ET 20 50 J ET 21 J ET
13. 38 42 PCM 71 00 01 TL Ed 3 6 2 MN 9324
14. JE
15. 6 7 8 9 f 1
16. ee TEL FAX E mail 4 II 0 a PSE RE 701 PSE RE 402 PSE RE 703 ON MN PSE 6 403 PSE RE 404 CB CB 6
17. 2 1 1 2 1 42 PCM 71 00 01 TL Ed 3 6 PSE RE 205 306 405 JET 2
18. 1 HH gt gt 2 3 6 4
19. 1 2 2 NN 72 000 ET 1 5 2 D 30 OOO Hl 2 12 000 1 1 2 6 000 2 2 3 000
20. ABS 1 2 3 1 2 3 hE RON 100V 35VA 50 60Hz 12V 2 2A 4 27 42 PCM 71 00 01 TL Ed 3 6 2
21. J ET ee 18 JETT 19 J ET ET 20 50 J ET 21
22. 2 1 8 1 3 9 2 3 42 PCM 71 00 01 TL Ed 3 6 lt 1 2 3
23. PP 1 1 5 2 2 0 5 0 5 in 0 5 0 5 0 5 500
24. 8 9 14 42 PCM 71 00 01 TL Ed 3 6 PSE RE 302 JET
25. P SE E 7 JE 8 J ET 9 RM 11 12 J ET EN 13
26. 500 1 1 5 2 2 31 42 PCM 71 00 01 TL Ed 3 6 0 5 0 5 0 5 0 5 0 5 500
27. Q 1 5 2 2 0 5 0 5 0 5 0 5 0 5 33 42 PSE RE 703 1 8 OOOGO PCM 71 00 01 TL Ed 3 6
28. 8 JETT ET 9 50 J ET 20
29. PCM 71 00 01 TL Ed 3 6 TE AX E 18 42 1 PCM 71 00 01 TL Ed 3 6 1 2 7 PSE RE 306
30. Direction for reaching the factory Please make sure the nearest railway station the airport and attach a copy of local map 4 Name of applicant or his representative in Block 5 Signature 6 Date of signature JRET In the case a certified testing laboratory authorized to conduct factory Inspection at your factory snte by JET asks you to pay the inspection fee to the laboratory please do so 29 42 PCM 71 00 01 TL Ed 3 6 15 100V
31. PCM 71 00 01 TL Ed 3 6 4 2 PSE RE 701 4 3 RSE RE 702 4 4 4 5 i 4 6 RSE RE 703 1 1 5 6 42 PCM 71 00 01 TL Ed 3 6 2 JE 9 1
32. Q 1 5 2 2 DC 0 5 500 1 1 5 2 2 tS 0 5
33. 3 1 ON OFF RK 1 4 1 2 3 3 1 2 1 2 L 26 42 PCM 71 00 01 TL Ed 3 6
34. 5 8 6 P SE E 7 JE 8 JE 9 10 12
35. gt 13 ET 14 _ JET 1 A 40 2 6 JE 7 E
36. 12 42 PCM 71 00 01 TL Ed 3 6 2 JE H 9 1 PSE RE 306 1 TEL FAX E mail 2 3 4 5 6 7 13 42 PCM 71 00 01 TL Ed 3 6 PSE RE 301 1
37. 3 as 17 28 42 PCM 71 00 01 TL Ed 3 6 PSE Scheme Operational and Regulatory Documents OBJETPSEOOO8 Ed 1 0 To Applicant Project No Questionnaire for scheduling the Authorized Inspection Facilities Field Verification 1 Manufacturer s registered name and factory address 2 Contact person in factory Department Function Telephone Telefax Deputy contact person in factory Department Function Tfdifferent from the above Telephone Telefax 3
38. J 13 JET gt 14 J ET 15 JE HER PT 40 2
39. 2 6 000 3 20 000 12 000 36 000 48 000 60 000 12 000 J Ni O 0 36 42 PCM 71 00 01 TL Ed 3 6 4 10 000
40. 2 JET 7 gt G 151 8545 5 14 12 Tel 03 3466 5234 Fax 03 3466 9219 E mail tokyo jet or jp gt G 230 0004 1 12 30 Tel 045 582 2151 Fax 045 582 2671 E mail yokohama jet or jp gt G 658 0003 4 1 Tel 078 771 5135 Fax 078 771 5136 E mail kansai jet or jp 4 42 PCM 71 00 01 TL Ed 3 6 8 460 0008 8 2 3 4F Tel 052 269 8140 Fax 052 269 8498 E mail nagoya jet or jp gt 812 0011 1 15 20 NOF 2F Tel 092 419 2385 Fax 092 419 2386 E mail kyusyu jet o
41. 6 et 40 2 4 1 5 2 6 1 1 0
42. 3 CM CM CM J 42 42
43. PSE RE 205 1 TEL FAX E mail 3 Pi Pa 4 5 6 7 42 PCM 71 00 01 TL Ed 3 6 PSE RE 201 1 3 JET 2
44. 8 42 PCM 71 00 01 TL Ed 3 6 PSE RE 202 JET 1 JET 2 2 4 1 2 3 4 9 42 PCM 71 00 01 TL Ed 3 6 PSE RE 203 JET ff J ET
45. 0 5 2 0 5 Os 500 Q 1 5 32 42 PCM 71 00 01 TL Ed 3 6 2 2 0 5 0 5
46. 30 42 PCM 71 00 01 TL Ed 3 6 0 5 1 1C 48 500 500 KO 1 1 5 2 2
47. 1 AI SS gt gt 2 3 6 4 5 8 6
48. TEL FAX E mail 2 TEL FAX E mail 10 42 PCM 71 00 01 TL Ed 3 6 PSE RE 204 ER FAX 11 42 Ei EN 1 6 PCM 71 00 01 TL Ed 3 6 PSE RE 205
49. TEL FAX E mail 23 42 PCM 71 00 01 TL Ed 3 6 PSE RE 404 EES FAX 24 42 PSE RE 405 PCM 71 00 01 TL Ed 3 6 1
50. 2 JET H 8 m JET PSE RE 802 3 lt PSR RE 701 gt PSE RE 303
51. JET gt gt 14 ET 15 JET Mo NUM NO 40 2 ae J ET DN 18 AAL JET
52. Name of Specified Electrical Appliances and Materials Applied Standard for Testing Description of the technical requirements by the METI Ordinance APPENDIX Type Classification As shown in the attachment gt SEE Description of the construction material and performance of the Specified Electrical Appliances and Materials which is to be manufactured amp As shown in the attachment Factory As shown in the attachment xs OfGcial duplicate of the Statement of Conformity need coples Not necessary 20 42 PCM 71 00 01 TL Ed 3 6 PSE RE 401 JET 1 JET 2
53. 10 000 5 6 37 42 PCM 71 00 01 TL Ed 3 6 1
54. ET 25 42 2 125 V PCM 71 00 01 TL Ed 3 6 100V 1 10 VA 2 10 VA 20 VA 30 VA 40 VA 35VA OE 50 60Hz 2 Q 5 V 15 V 30 V 3 80 V 60 V 60 V 12V 1 2 A sR NE 1 2
55. 2 1 2 41 42 PCM 71 00 01 TL Ed 3 6 CM J CM 7 y CM 8 000 CM 6 000 6 000 6 000 9 000 PT 20 000 3 12 000
56. RN RE o 0 gt 2 3 6 4 2 FE
57. 2 3 2 1 2 16 42 PCM 71 00 01 TL Ed 3 6 PSE RE 304 JET ff J ET
58. Q 1 5 2 2 A 100V Q 1 5 2 2
59. 2013 04 01 1 OOOGO 500V 500 V 2013 04 01 2013 04 01 1 5 2013 04 01 1 1 100V OT 2 2013 04 01 130 V 1 1 2 kVA 150 300 V 0 5 2013 04 01 04 RA AAAAA 1 Ee 0 15730A 0 5 6 OOOO it 1 3 500 C O OOO RC 0 01 34 42 PCM 71 00 01 TL Ed 3 6 ka 1 1 2013 04 01 2 1 150 300V 0 5 2013 04 01 1 0 15 30 A 0 5 2013 04 01 1 120 240 V 2013 04 01 1 35 42 PCM 71 00 01 TL Ed 3 6 2 1 Un EE
60. 1 JET 2 2 4 1 2 3 4 22 42 PCM 71 00 01 TL Ed 3 6 PSE RE 403 JET JE
61. NG 5 90 6 JE 7 JET 3 8 9 10 3 3 lt Eu 3 J ET
62. PSRE RE 703 6 PSE RE 305 CB CB 6 7 JE
63. 9 9 8 TEL FAX E mail 3 4 15 42 PCM 71 00 01 TL Ed 3 6 JET 1 Im PSE RE 303 1 E JET 2 3
64. PSE RE 701 1 ABC 1234P AC 3P 1 2 1 2 5 V 2 A 2 TN un
65. To be filled in by JET To Japan Electrical Safety amp Environment Technology Laboratories 9 1 2 We hereby apply for Conformity Assessment on the Specified Electrical Appliances and Materials listed below in order to obtain the Statement of Conformity thereon as specified in the Article 9 Paragraph 1 of Electrical Appliances and Materials Safety Act PSE RE 405 We submit this application accepting Conditions for Application for Conformity Assessment PSE RE 405 on the attachment to the applcation Ts Applicant manufacturer outside Japan Company name Address Name of the responsible person for this application Signature oy seal Divsion name Managerial post TEL FAX E mail Address of the responsible person If different om the above one of the Company er
66. 1 1 2 3 9 1 2 2 1 9 1 1 2 1 i 2
67. TET PSE RE 201 PSE RE 301 PSE RE 401 a PSE RE 302 PSE RE 202 PSE RE 303 PSE RE 402 PSE RE 203 PSE RE 304 PSE RE 403 PSE RE 204 PSE RE 305 PSE RE 404 PSE RE 205 PSE RE 306 PSE RE 405 JET IN EN te MBK PSE RE 702 PSE
68. PSE RE 703 CB CB 2 42 PCM 71 00 01 TL Ed 3 6 3 sm 1 2 1 2 ty 6
69. PCM 71 00 01 TL Ed 3 6 ET 2014 05 PCM 71 00 01 TL Ed 3 6 36 234 9 26 5 JET JE 1
70. r jp gt JET http www jet or jp 5 42 1 1 2 1 1 1 2 PSE RE 201 1 3 PSE RE 202 1 4 PSE RE 203 1 5 PSE RE 204 1 6 PSE RE 205 0 2 2 2 1 2 2 PSE RE 301 2 3 PSE RE 302 2 4 PSE RE 303 2 5 PSE RE 304 2 6 PSE RE 305 2 7 PSE RE 306 3 8 1 3 2 PSE RE 401 3 3 PSE RE 402 3 4 PSE RE 403 3 5 PSE RE 404 3 6 PSE RE 405 4 4 1
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