ENVIRONMENTAL, HEALTH AND SAFETY (EH&S)

FORM For Components

Spp!"er "n#orm$t"on%
Comp!et"on &$te%
Comp$n' N$me%
Cont$(t po"nt n$me%
e-mail: Phone:
Please return the completed questionnaire and its annex to: A!($te!)L(ent
Attn:
Email Address:
*ENERAL EH&S INFORMATION
+, Does 'or (omp$n' -$.e $ He$!t- & S$#et' /o!"(' "n p!$(e0
Yes No
If yes, please provide an electronic copy of the policy, or provide a URL e! site
address here the policy can !e vieed:
If not, please descri!e ho your company mana"es occupational #ealth and $afety
matters %scope, process documentation, trainin" plans, incident mana"ement etc&' :

1, Does 'or (omp$n' -$.e $n En."ronment$! /o!"(' "n p!$(e0

Yes No
If yes, please provide an electronic copy of the policy, or provide a URL e! site
address here the policy can !e vieed:
If not, please descri!e, if any, internal processes and(or documents, containin" your
company commitments to environment o!)ectives:
2, H$s 'or (omp$n' "mp!emente& $n En."ronment$! M$n$3ement S'stem
(o.er"n3 $t m"n"mm $!! "ts m$n#$(tr"n3 s"tes0
Yes No
If not, are there plans to have one implemented* Please specify any plans and time
frame for implementation of these plans:
If yes, is it the Environmental +ana"ement $ystem I$, -.//-certi0ed (E+A$
re"istered(any others*
Ref& E#1$23orm24 -(-/ Edition date: +ay 5//6
Please specify:
Please list the locations certi0ed or re"istered accordin"ly:
4, 5-$t "s (o.ere& "n 'or (omp$n'6s En."ronment po!"("es0
(please check the appropriate boxes below)
Hazardous Substances and Chemicals
(e.g., material handling, storage, recycling, disposal, spill control)
Waste Management
(e.g., waste stream monitoring, control, treatment, disposal)
Enironmentally Conscious !esign
(e.g., enironmental aspects in the design phase o" products,
restriction in the use o" hazardous substances such as in #oHS)
$ollution $reention
(e.g., energy and resource conseration, waste reduction, pac%aging)
&ir Emissions
(e.g., emission characterization, monitoring, control, mitigation)
Enironmental $ermits
(e.g., permit registration, maintenance, compliance reporting)
'ther ($lease speci"ic () )
7, Does 'or (omp$n' (ons"&er En."ronment$!, He$!t- $n& S$#et' "sses "n
se!e(t"n3 "ts spp!"ers $n&8 or 9s"ness p$rtners0
Yes
Ho:0
No
*" your company has not considered
health, sa"ety and enironmental issues
with regard to its relations with its
suppliers and+or partners, are there
plans to do so,
Yes Within what time "rame,
No
Comments
;, 5-$t pro(esses or ot-er me(-$n"sms &o 'o -$.e "n p!$(e to ensre t-$t
'or spp!"ers pro."&e 'o :"t- pro&(ts $n& (omponents (omp!"$nt to
re3!$t"ons $n&8or (stomer re<"rements0
=, Does 'or (omp$n' m$>e en."ronment$!!' re!$te& "n#orm$t"on $.$"!$?!e
on "ts :e? s"te ?e t-e' re!$te& to t-e En."ronment M$n$3ement S'stem or
to pro&(t #e$tres0
Yes No
If yes, please descri!e information availa!le on the internet and provide the URL
e! site address%es':
Ref& E#1$23orm24 5(-/ Edition date: +ay 5//6
Included in the policies
Included in the purchasing
contracts
Included in any partner
agreement
Included in supplier
/partner evaluation
processes
Other
($lease be more speci"ic)

/ROD@CT EH&S INFORMATION

Answers to the following questions may be used by Alcatel-Lucent to develop ECMA type
ecodeclaration for its own products
(see ECMA standard !"# http#$$www%ecma-international%org$publications$standards$Ecma-
!"%htm &%
T-e (ontr$(t m$' (o.er se.er$! pro&(t #$m"!"es8 t'pes, /!e$se spe("#' #or e$(-
$ns:er t-e set o# pro&(ts to :-"(- "t $pp!"es,
S?st$n(es "n pro&(ts
T-e pro&(ts &e!".ere& to A!($te!)L(ent m$' ?e "nte3r$te& "n e<"pment s?Ae(t
to t-e E@ RoHS D"re(t".e 1BB18C78CE "n :-"(- ($se "t "s s?Ae(t to t-e s?st$n(e
se restr"(t"ons $s &eDne& "n t-e ERoHS D"re(t".e6,
7, T$>"n3 "nto (ons"&er$t"on t-e $?o.e st$tement, p!e$se $ns:er t-e
#o!!o:"n3 <est"ons,
Do 'or pro&(ts (omp!' :"t- t-e Restr"(t"on on H$F$r&os S?st$n(es
(RoHS) $s &eDne& "n E@ D"re(t".e 1BB18C78EC 0
7es 8o
Please list product families to hich your anser applies:
;, I# 'es to <est"on G+, &o 'or pro&(ts (omp!' t-ro3- t-e se o# (ert$"n
eHempt"ons !"ste& "n D"re(t".e 1BB18C78EC $n& $sso("$te& &e("s"ons
"n(!&"n3 1BB78=4=8EC, 1BB78=+=8EC, 1BB;82+B8EC, 1BB;8;C+8EC,
1BB;8;C18EC $n& 1BB;8;CB8EC (see "n&"($t".e eHempt"on !"st "n AnneH +)
7es 8o
Please list exemptions used per product( product family:
Alcatel-Lucent may request further detailed technical information at the item/
part number level in relation to substance content and product characteristics.
Please provide either a URL address or a contact name for Alcatel-Lucent for
questions and/or further information on your products characteristics in
relation to substance restrictions e.!." solder temperature" etc.#:
T-e pro&(ts &e!".ere& to A!($te!)L(ent m$' ?e "nte3r$te& "n e<"pment s?Ae(t
to t-e C-"n$ A&m"n"str$t".e Me$sre on t-e Contro! o# /o!!t"on C$se& ?'
E!e(tron"( In#orm$t"on /ro&(ts o# or&er No, 2C o# 1BB;)B1)1I $!so n$me&
C-"n$ RoHS, An' pro&(t &e!".ere& to A!($te!)L(ent mst (omp!' :"t- C-"n$
RoHS $n& "ts $sso("$te& st$n&$r&s re<"rements on pro&(t m$r>"n3, pro&(t
"n#orm$t"on $n& p$(>$3"n3 m$r>"n3 :-en re!e.$nt,
=, Do 'or pro&(ts (omp!' :"t- t-e $?o.e !"ste& C-"n$ RoHS re<"rements0
7es 8o
Please list product families to hich your anser applies:
I, Are per(-!or$te m$ter"$!s present "n t-"s pro&(t t-$t re<"re not"D($t"on
"n $((or&$n(e :"t- C$!"#orn"$ (@SA) /er(-!or$te M$ter"$!s M$n$3ement
L$: (C$!"#orn"$ /er(-!or$te Cont$m"n$t"on /re.ent"on A(t)0
7es 8o
Ref& E#1$23orm24 9(-/ Edition date: +ay 5//6
Please list product families to hich your anser applies:
C, Does $n' o# 'or pro&(ts (ont$"n $n' o# t-e s?st$n(es !"ste& "n section
$" %able & as 'A(()* o# t-e A!($te!)L(ent Spp!"er Re<"rements on
s?st$n(e restr"(t"ons (+AA BB1;; BB27 ASJJA) :-"(- :$s "ntent"on$!!'
$&&e&, ",e,, "n (on(entr$t"ons eH(ee&"n3 t-e n$tr$! ?$(>3ron& !e.e!s0
7es 8o
If yes, 2 please specify the su!stance%s' and its application:
2 please list product families to hich your anser applies:
+B,Does $n' o# 'or pro&(ts (ont$"n $n' o# t-e s?st$n(es !"ste& "n section
$" %able & as R)+%R,-%)* o# t-e A!($te!)L(ent Spp!"er Re<"rements on
s?st$n(e restr"(t"ons (+AA BB1;; BB27 ASJJA) ?e'on& t-e spe("De&
!e.e!s0
7es 8o
If yes, 2 please specify the su!stance%s' and its application:
2 please list product families to hich your anser applies:
++,Does $n' o# 'or pro&(ts (ont$"n $n' o# t-e s?st$n(es !"ste& "n section
. +U'+%A(-)+ %/ ') A0/,*)* o# t-e A!($te!)L(ent Spp!"er
Re<"rements on s?st$n(e restr"(t"ons (+AA BB1;; BB27 ASJJA) :-"(-
:$s "ntent"on$!!' $&&e&, ",e,, "n (on(entr$t"ons eH(ee&"n3 t-e n$tr$!
?$(>3ron& !e.e!s0
7es 8o
If yes, 2 please specify the su!stance%s' and its application:
2 please list product families to hich your anser applies:
Tr$nsport$t"on /$(>$3"n3 M$ter"$!s
+1,Do t-e tr$nsport$t"on p$(>$3"n3 m$ter"$!s (omp!' :"t- Erope$n
p$(>$3"n3 &"re(t".e (C48;18EC)0
7es 8o
4omments:

,ther re"ulations or standards* 7es 8o
Please specify:
+2,Do 'o -$.e $n' t$>e ?$(> oKer #or p$(>$3"n30
7es 8o
If yes, please descri!e %countries covered, ho to request collection, conditions for
collection, etc&':
En&)o#)L"#e Tre$tment
Ref& E#1$23orm24 .(-/ Edition date: +ay 5//6
+4,Are Lor"n$te& 3$ses $s &eDne& "n t-e E@ F!or"n$te& *$s Re3!$t"on
(2006/842/EC) )e,3,, s!#r -eH$Lor"&e ) present "n $n' o# 'or pro&(ts
and intentionally added, i&e&, in concentrations exceedin" the natural !ac:"round
levels0
7es 8o
If yes, please specify product family:
If yes, please list product families to hich your anser applies:
/!e$se pro."&e en& o# !"#e tre$tment "n#orm$t"on #or 'or pro&(ts, $t !e$st
(o.er"n3 "tems !"ste& "n AnneH 1, e"t-er ?' sen&"n3 &o(ment$t"on $tt$(-e& to
t-"s (omp!ete& EH&S #orm, or ?' re#err"n3 to t-e @RL :e?s"te $&&ress(es) :-ere
"n#orm$t"on ($n ?e #on&%
Ref& E#1$23orm24 ;(-/ Edition date: +ay 5//6
ANNEN +%
L"st o# RoHS eHempt"ons
<he list of exemption included in this questionnaire is !ased on exemptions for hich a
decision has !een made !y relevant European !odies as of 3e!ruary 5//=&
-& +ercury in compact >uorescent lamps not exceedin" ; m" per lamp&
5& +ercury in strai"ht >uorescent lamps for "eneral purposes not exceedin":
? halophosphate -/ m"
? triphosphate ith normal lifetime ; m"
? triphosphate ith lon" lifetime @ m"&
9& +ercury in strai"ht >uorescent lamps for special purposes&
.& +ercury in other lamps not speci0cally mentioned in this Annex&
;& Lead in "lass of cathode ray tu!es, electronic components and >uorescent
tu!es&
A& Lead as an alloyin" element in steel containin" up to /,9; B lead !y ei"ht,
aluminum containin" up to /,. B lead !y ei"ht and as a copper alloy
containin" up to . B lead !y ei"ht&
=& ? Lead in hi"h meltin" temperature type solders %i&e& lead !ased alloys
containin" @; B !y ei"ht or more lead',
? lead in solders for servers
-
, stora"e and stora"e array systems, netor:
infrastructure equipment for sitchin", si"nalin", and transmission as ell
as netor: mana"ement for telecommunications,
? lead in electronic ceramic parts %e&"& pieCoelectronic devices'&D
@& 4admium and its compounds in electrical contacts and cadmium platin"
except for applications !anned under Eirective 6-(99@(EE4 %-' amendin"
Eirective =A(=A6(EE4 %5' relatin" to restrictions on the mar:etin" and use of
certain dan"erous su!stances and preparations&
6& #exavalent chromium as an anti2corrosion of the car!on steel coolin"
system in a!sorption refri"erators&
6a& FAnnulledG Eeca HEE in polymeric applications&
6!& P! in lead !ronCe !earin" shells and !ushes&
-
3or the purpose of the exemption, IsolderD is de0ned as the Alloys used to create
metallur"ical !onds !eteen to or more metal surfaces to achieve an electrical and(or
physical connection& <he term IsolderD also includes all materials that !ecome part of
the 0nal solder )oint, includin" solder 0nishes on components or printed circuit !oards&
Ref& E#1$23orm24 A(-/ Edition date: +ay 5//6
-/&
--&Lead used in compliant pin connector systems&
-5&Lead as a coatin" material for the thermal conduction module c2rin"&
-9&Lead and cadmium in optical and 0lter "lass&
-.&Lead in solders consistin" of more than to elements for the connection
!eteen the pins and the pac:a"e of microprocessors ith a lead content of
more than @/B and less than @;B !y ei"ht&
-;&Lead in solders to complete a via!le electrical connection !eteen
semiconductor die and carrier ithin inte"rated circuit 3lip 4hip pac:a"es&
-A&Lead in linear incandescent lamps ith silicate coated tu!es&
-=&Lead halide as radiant a"ent in #i"h Intensity Eischar"e %#IE' lamps used
for professional repro"raphy applications&
-@&Lead as activator in the >uorescent poder %- B lead !y ei"ht or less' of
dischar"e lamps hen used as sun tannin" lamps containin" phosphors
such as H$P %Ha$i5,;:P!' as ell as hen used as speciality lamps for
diaCo2printin" repro"raphy, litho"raphy, insect traps, photochemical and
curin" processes containin" phosphors such as $+$ %%$r,Ha'5+"$i5,=:P!'&
-6&Lead ith P!Hi$n2#" and P!In$n2#" in speci0c compositions as main
amal"am and ith P!$n2#" as auxiliary amal"am in very compact Ener"y
$avin" Lamps %E$L'&
5/&Lead oxide in "lass used for !ondin" front and rear su!strates of >at
>uorescent lamps used for Liquid 4rystal Eisplays %L4E'&
5-&Lead and cadmium in printin" in:s for the application of enamels on
!orosilicate "lass&
55&Lead as impurity in RIJ %rare earth iron "arnet' 3araday rotators used for
0!re optic communications systems&
59&Lead in 0nishes of 0ne pitch components other than connectors ith a pitch
of /&A; mm or less ith 8i3e lead frames and lead in 0nishes of 0ne pitch
components other than connectors ith a pitch of /&A; mm or less ith
copper lead2frames&
5.&Lead in solders for the solderin" to machined throu"h hole discoidal and
planar array ceramic multilayer capacitors&
5;&Lead oxide in plasma display panels %PEP' and surface conduction electron
emitter displays %$EE' used in structural elementsK nota!ly in the front and
rear "lass dielectric layer, the !us electrode, the !lac: stripe, the address
electrode, the !arrier ri!s, the seal frit and frit rin" as ell as in print pastes&
5A&Lead oxide in the "lass envelope of Hlac: Li"ht Hlue %HLH' lamps&
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5=&Lead alloys as solder for transducers used in hi"h2poered %desi"nated to
operate for several hours at acoustic poer levels of -5; dH $PL and a!ove'
loudspea:ers&
5@&FExpiredG #exavalent chromium in corrosive preventive coatin"s of
unpainted metal sheetin"s and fasteners used for corrosion protection and
Electroma"netic Interface $hieldin" in equipment fallin" under cate"ory
three of Eirective 5//5(6A(E4 %I< and telecommunications equipment'&
Exemption "ranted until - Luly 5//=&
56&Lead !ound in crystal "lass as de0ned in Annex I %4ate"ories -, 5, 9, and .'
of 4ouncil Eirective A6(.69(EE4&
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ANNEN 1

In#orm$t"on to ?e m$&e $.$"!$?!e to re('(!ers
&
Producer: Mcompany name, other on addressin" the producerN
$cope of information sheet: M product cate"ory as in Annex IA of OEEE Eirective, or type
of equipment as in Annex -H of OEEE Eirective, or
producerPs Product 3amily, or sin"le products identi0ed !y
!rand and model name N
Component or M$ter"$! Rem$r>s 8 Lo($t"on
Hattery %internal Q' containin" +ercury %#"'(
8i4ad(Lithium( ,ther
Hac:li"htin" lamps of L4E(<3< or similar screens
containin" +ercury %#"'
+ercury %#"' in other applicationsQQ
4admiumQQ
Jas dischar"e lamps
Plastic containin" !rominated >ame retardants other than
in Printed 4ircuit Assem!lies QQQ
Liquid 4rystal Eisplays ith a surface "reater than -//
cm5
4apacitors ith P4HRs
4apacitors ith su!stances of concernQQQQ S hei"ht N 5;
mm, diameter N 5; mm or proportionately similar
volume
As!estos
Refractory ceramic 0!res
Radio2active su!stances
Heryllium ,xide
,ther forms of Heryllium
Jasses 2 hich fall under Re"ulation %E4' 5/9=(5/// and
all hydrocar!ons %#4'&
Mtype of "as, properties,
volume and(or ei"htN
4omponents ith pressurised "as hich need special
attention %Pressure N -,; !ar' QQQQQ
Mtype of "as, pressure level,
dischar"e methodN
Liquids QQQQQ if volume N -/ cl %or equivalence in
ei"ht, e&"& for P4H, oil&&&'
Mtype of liquid, dischar"e
methodN
+echanical components that store mechanical ener"y
%i&e& sprin"s' or equivalent parts hich need special
attention QQQQQ
%diameter N -/ mm and hei"ht N 5; mm or
proportionally similar volume and expandin"'
T Arro indicates the need for the location of the compartment ( su!stances
ithin the product& Ohen the location of su!stance( components is requested, it is
at the part level, e&"&, main !oard, housin", etc&
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Q Internal means that !atteries can only !e removed !y openin" the product !y
means of tool%s'&
QQ $u!stances are considered to !e in the product if present a!ove the levels
speci0ed in 4ommission Eecision 5//;(A-@(E4 related to Eirective 5//5(6;(%E4'
%Ro#$ Eirective' or if their use is permitted throu"h exemptions in the Annex of
Eirective 5//5(6;%E4'&
QQQ <o !e coherent ith industry current standards and practices on trac:in" of
plastic parts, Eirective 5//5(6A %E4' Annex II requirement is understood to focus
on plastic parts that ei"ht more than 5; "&
QQQQ $u!stance of concern other than P4H, to !e speci0ed( addressed further in the
context of Eirective 5//5(6A %E4' Annex II national requirements and European
developments
QQQQQ 8eeds of equivalent nature as those for maintenance, service manuals and
installation for safety purposes&
NOTE% A!($te!)L(ent "n#orm$t"on re<"rements "s "n !"ne :"t- t-e $3reement
re$(-e& ?et:een t-e Erope$n E!e(tron"( Re('(!"n3 Asso("$t"on (EERA),
Erope$n In#orm$t"on, Commn"($t"ons $n& Consmer E!e(tron"(s Te(-no!o3'
In&str' Asso("$t"ons (EICTA), Erope$n Comm"ttee o# Domest"( E<"pment
M$n#$(trers (Ce(e&), $n& t-e Amer"($n E!e(tron"( Asso("$t"on Erope (AeA
Erope) on "n#orm$t"on t-$t t-e e<"pment pro&(er s-o!& -$.e $.$"!$?!e #or
re('(!ers pon re<est,
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