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         DOCUMENT NO: ASAP 5009 VERSION: 2010-10-25 Page 1 of 8
         TITLE: Application Procedure for Acceptance of Conduit Hose, Fire Suppression
         Hose and Fire Hose Liner for Use in Underground Coal Mines
        MSHA Mine Safety and Health Administration, Approval & Certification Center
                     (电话:4000136580       0571-85860756唐先生)

1.0 PURPOSE
This document establishes the Mine Safety and Health Administration’s (MSHA)
Standard Application Procedure (SAP) for the acceptance of Hose Conduit, Fire
Hose Liner and Fire Suppression Hose under 30 CFR, Part 18.
2.0 SCOPE
These procedures apply to all applications for acceptances of Hose Conduit, Fire
Hose Liner and Fire Suppression Hose under 30 CFR, Part 18.
3.0 REFERENCES
3.1. Approval and Certification Center (A&CC) Cancellation Policy (APOL
1009).
3.2. Code of Federal Regulations (30CFR) Parts 18.65, 75.1100-1(f)(1) and
75.1107-13(c).
4.0 DEFINITIONS 4.1. Fire Hose Liner: The innermost tube of a fire hose.
4.2. Fire Suppression Hose: A hose used on a fire suppression device.
4.3. Hose Conduit: A protective hose used over electrical cables. Hose conduit
is not to be split.
5.0 APPLICATION PROCEDURE
5.1. It is recommended that applicants contact the Quality Assurance &
Materials Safety Division at 304-547-0400 to discuss acceptance and testing
requirements prior to submitting an application. 5.2. The application requesting an acceptance or extension of acceptance should
be sent to the following address:
MSHA, Approval and Certification Center
Attention: IPSO
765 Technology Drive
Triadelphia, West Virginia 26059
a. FAX to: 304-547-2084
b. Email Submittals:
c. Application letters, specifications, drawings and other supporting
documentation should be sent to zzMSHA-IPSO@DOL.gov
d. FTP Submittals:
e. Application letters and supporting documentation can be placed on
the MSHA FTP server, mfgr.msha.gov. Please call the Information
Processing Services Office (IPSO) at 304-547-0400 to establish your user
account.
5.2.1. Each application for acceptance of a product must be in the English
Language and include the following information on the attached
application form (Attachment 1, Item 1).
a. Company name
b. Address
c. Telephone & FAX number of company representative
d. Company representative name
5.2.2. A 6 digit or less numeric code (Application Code) assigned by the
applicant (Attachment 1, Item 2).
5.2.3. Identify if the application request is for a new acceptance or an extension
of an existing acceptance number (Attachment 1, Item 3).
5.2.4. Identify and describe the product (as applicable) on Attachment 1, Item 4.
Additional information and any special information should be attached.
5.2.5. Provide information on the compounds in the product: Each ingredient
must be specified by its chemical or generic name along with its
percentage (weight) and tolerance (Attachment 2, Item 5). Organic
ingredients should be named according to the current rules of the
International Union of Pure and Applied Chemistry. Inorganic
ingredients should be named according to the Chemical Abstract of the
American Chemical Society. A prepolymer formulation which has been
registered with MSHA may be identified by furnishing the MSHA
assigned ID number. However, each additional ingredient the
manufacturer adds to the chemical or generic name, along with its
percentage (weight) and tolerance must be identified by chemical or
generic name, along with its percentage (weight) and tolerance. Use one
of the methods listed below in 5.2.5.1, 5.2.5.2 or 5.2.5.3 (Attachment 1, Item
5).
5.2.5.1. Specify each ingredient by its chemical name along with its percentage
(weight) and tolerance or percentage range. Organic ingredients should
be named according to the current rules of the International Union of
Pure and Applied Chemistry. Inorganic ingredients should be named
according to the Chemical Abstract of the American Chemical Society.
5.2.5.2. Specify each fire retardant ingredient by its chemical or generic name
with its percentage and tolerance or percentage range or its minimum
percent. List each flammable ingredient by chemical, generic, or trade
name along with the TOTAL percentage of all flammable ingredients.
List each inert ingredient by chemical, generic, or trade name along with
the TOTAL percentage of all inert ingredients. In addition, the product
formulation with percentages and tolerances should be kept on file by
the applicant. The formulation shall be available to MSHA at the
applicant’s premises upon request should a product be involved in a
mine accident, incident, or quality assurance check.
5.2.5.3. Specify each fire retardant ingredient by its chemical or generic name
with its percentage and tolerance or percentage range or its minimum
percent. List all other ingredients. A flame test quality assurance
program subject to acceptance by the Approval and Certification Center,
Quality Assurance and Materials Testing Division should also be
provided to maintain the accepted flame resistance level of the product.
The flame test program should be maintained and documented as long
as the product is made and acceptance is in effect. The flame test
records should be available for examination by MSHA personnel. In
addition, the product formulation with percentages and tolerances
should be available to MSHA at the applicant’s premises upon request
should a product be involved in a mine accident, incident, or quality
assurance check.
5.2.6. Quality Assurance:
Provide information on the applicant’s quality assurance program
regarding the procedures used to maintain compliance with criteria.
MSHA reserves the right to monitor in-plant processes, review records,
and interview employees with respect to the plan. Any changes affecting
flammability or toxicity in the quality assurance program will require re-
acceptance by MSHA. The quality assurance program shall include
(Attachment 2, Item 6):
a. Procurement procedures for the components of the product.
b. Manufacturing practices to maintain the formulation.
c. Procedures for record keeping.
d. If option 5.2.5.3 above is used for the formulation, details of a flame
test control program must be included as part of a quality
assurance program.
5.2.7. Flammability Testing: Hose samples to be tested by MSHA (Attachment
2, Item 7).
a. For Hose Conduit:
Submit 6 samples ½" wide by 6" long of the complete wall section.
In addition, submit a 3-foot long complete hose section.
b. For Fire Suppression Hose:
Submit 6 samples ½" wide by 6" long of the outer jacket/cover.
c. For Fire Hose Liner:
Submit 6 samples ½" wide by 6" long of the inner tube liner.
5.2.8. Provide information on the toxicity of the finished product including an
OSHA Materials Safety Data Sheet in accordance with 29 CFR 1910.1200.
This information should include the toxicity of the finished product
including inhalation, ingestion, skin, eye sensitization, and carcinogenic
hazards. A toxic product is a finished product or material capable of
causing bodily harm to an average individual by chemical action. The
toxicity hazard should be under “normal use conditions” (Attachment 2,
Item 8).
5.2.9. Changes in Composition of Accepted Products and Extensions:
MSHA’s Approval and Certification Center, Quality Assurance and
Materials Testing Division, may request specific formulation
information (name of ingredient(s) with percentage and tolerances)
and/or test data, if an applicant is requesting a change in composition of
an accepted product or requesting an extension. MSHA will determine
if the change increases the flammability or toxicity of the product.
5.2.10. Branding Information:
Hose and hose conduit submitted under 30 CFR 18.65 and accepted by
MSHA as flame-resistant shall be marked as follows: Impressed letters,
raised letters on depressed background, or printed letters with the
words “Flame-Resistant USMSHA No.18-HCAYYXXXX-0“at intervals
not exceeding 3 feet. This number will be assigned to the manufacturer
after the sample has passed the tests. For all hose and hose conduit
larger than 3/8 inch I.D., the letters and numbers shall be at least 1/4
inch high. For hose 3/8 inch I.D. and under, the letters and number
shall be at least 1/4 inch high. Multiple use hose submitted under this
application procedure and the Interim Criteria shall be marked “Flame-
Resistant, USMSHA No. 18-FSAYYXXXX-0“. This number will be
assigned to the manufacturer by MSHA.
5.2.11. The “A” in the acceptance number designates the applicable standard;
“YY” designates the year of the standard revision, the “XXXX” designates
the four digit acceptance number, and “0” designates the extension
number to be assigned by MSHA following acceptance of the conduit
hose, fire suppression hose or fire hose liner.
5.2.12. When acceptance is granted, the applicant must provide MSHA with a
sample showing the complete brand.
5.3. The material contained in your application is considered to be confidential
commercial information and/or trade secrets as covered by federal law (5
USC 552(b)(4)) and is exempt from disclosure requirements of the Freedom
of Information Act (5 USC 552).
           ASAP5009 2010-10-25.doc Print Date: 10/25/2010
PRINTED AND ELECTRONIC COPIES OF THIS DOCUMENT ARE
UNCONTROLLED. VERIFY CORRECT VERSION PRIOR TO USE. TSAP0001, Rev 02

Attachment 1
Application for Acceptance
of Conduit Hose, Fire Suppression Hose, and Fire Hose Liner
Date________________
1. Company Name: ______________________________________________________________ Address: _____________________________________________________________________ _____________________________________________________________________
Telephone No. (Area Code) ______________________ FAX No. ______________________
Company Representative: ______________________________________________________
2. Company Identification Code Number: __________________________________________
3. Application is for:
a. New MSHA Acceptance Number: Yes ___ No ___ b. Extension of an existing Acceptance: ______________________________________
(Insert Acceptance No.) 4. a. End Use Designation:
Fire Suppression ____________ Fire ____________ Hose Conduit _____________
Other (specify) ________________________________________________________
b. For FIRE HOSE LINER complete only the following: Tube (Inner Liner): Compound Designation No. ________________
Thickness Range _______________
c. For FIRE SUPPRESSION HOSE AND OTHER HOSE complete only the following: Cover: Compound Designation No. ______________
Thickness Range _______________
d. For HOSE CONDUIT complete the following information (d through g): Cover: Compound Designation No. ________________ Thickness Range ________________
Hose Conduit Wall Gauge (3/16” minimum ________________
e. Reinforcement Type:
Braided ________ Wrapped Fabric ________ Spiral/other (specify) _________
Material:
Textile ________ Wire _________
f. Fabric Reinforcement Details: Textile(s) Warp ______________ Weft (fill) ______________
Fabric Weight (oz./sq. yd. - Max.) _____________
Fabric Treatment ___________________________________________
No. of Plies: ________ Adhesion Gum Designation No(s). ________
g. Braided, Spiral, or Other Reinforcement Details:
Material Type ______________________________________________
Weight (yd./lb.; ft./lb.) _____________________________________
No. of Plies: ________ Adhesion Gum Designation No(s): _________
Attachment 2
5. Formulation Ingredient % by Weight Tolerance (+ or - Percent)
6. The following Quality Assurance documentation is attached:
a. Procurement procedures for the components or ingredients of the product,
Yes ___ No ___ (if No, provide explanation).
b. Manufacturing practices to maintain the formulation,
Yes ___ No ___ (if No, provide explanation).
c. Procedures for record keeping, such as inspection records, sampling plan, test results, etc.
Yes ___ No ___ (if No, provide explanation)
d. If option 5.2.5.3 above is used for the formulation, details of a flame test control program must be included as part of a quality assurance program. Yes ___ No ___ (if No, provide explanation).
7. The following samples were submitted for testing: a. For Hose Conduit: Yes ___ No ___
Submit 6 samples ½" wide by 6" long of the complete wall section. In addition, submit a 3-foot long complete hose section. b. For Fire Suppression Hose: Yes ___ No___
Submit 6 samples ½" wide by 6" long of the outer jacket/cover.
c. For Fire Hose Liner: Yes ___ No___
Submit 6 samples ½" wide by 6" long of the inner tube liner. 8. Toxicity Certification Statement:
I certify that _________________________________, in its final form does not present a toxicity
(Trade Name) hazard under normal use conditions. Furthermore, I certify that we will assure product
compliance of this product with respect to all specifications submitted to MSHA, A&CC. Signed _____________________________________ Title ____________________ Date _________
(Authorized Company Official)

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