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Environmental Survey Request

If you would like to request an environmental survey, please fill out the form below and submit.

*SDS and Certificate of Non-Use of Substances Covered by the RoHS Directive can be downloaded from this page.
*If you are unable to submit the form or have any problems, please contact us at "M-Quality@chukoh.co.jp".
*Please note that it may take some time depending on the contents.
*If you have more than one product to apply for, please enter the details in the remarks column.
*If you would like to use the designated form, please reply with the form attached to the e-mail we will send you after your application is complete.

  • Examples: FGF-300-6, AGF-100, TUF-100, etc.

  • Example:L123456M23G
    If you have not purchased any of the surveyed products, please enter “None”.

  • *Please indicate “thickness x width x length” or “outer diameter x inner diameter x length.








  • *Please check all that apply.
    *If the survey contents differ for each product, please enter the details in 【13】.
    *If you would like a Declaration of Food Sanitation Act, please enter the “Purpose of Use,” “Food Category,” and “Operating Temperature” in 【13】.
    *If you wish to use IMDS, please make sure to enter your “Company ID” in 【9】.

  • *If you have attachments, please attach them to the “Receipt Completion E-mail” sent by our company after the application is completed and reply to it.

  • *Please enter any laws, regulations, surveyed substances, etc. specified.
    *If the survey details differ for each product, please provide details.

  • Please provide the applicant's contact information.

  • - -

    Example) 090-1234-5678
    *Enter half-width characters


  • Confirmation of entered e-mail (Please enter again)

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