| Entry # | U10-3120767-7 |
| Invoice # | CI1214802 nk |
| Name of Importer | Richard Shields |
| Address of Importer | 1500 E. Washington St. Muncie, IN 47305 |
| Date of Declaration | 05-01-2012 |
| Item # | lc9521 |
| Item Name | 30 assorted Cake |
| Date of Mfg. | 12-13-2011 |
| Product Category | Mine & Shell Devices |
| CPSC Reg. Code | 16 CDF 1500.14(b)(7), 16 CFR 1507, 16 CFR 1500.17(a)(3), 16 CFR 1500.121 |
| Test Lot ID | 11X03961 |
| Test Date | 12-15-2011 |
PRODUCT IS MANUFACTURED AND TESTED IN CHINA DECLARATION: The importer shown above declares that the shipment of consumer fireworks identified above has been tested and certified by a third party as conforming to all applicable regulations, standards and bans enforced by the U.S. Consumer Product Safety Commission, except those items noted below (Includes items not required to be tested, such as fireworks samples, unfinished fireworks, fuse, punk sticks, supplies, etc.): CONTACT INFORMATION FOR LABORATORY THAT PERFORMED CONFORMITY TESTING. |
|
| Name | American Fireworks Standards Laboratory |
| Address | 7316 Wisconsin Avenue, Suite 214 Bethesda MD 20814 |
| Phone | 301-907-9115 |
| Fax | 301.907.9117 |
| afslhq@afsl.org | |
CONTACT INFORMATION FOR INDIVIDUAL MAINTAINING RECORDS ON WHICH DECLARTION IS BASED. |
|
| Name | Richard Shields, President/Owner |
| Address | North Central Industries, Inc 1500 E Washington St. Muncie, IN 47305 |
| Phone # | 765-284-7122 |
| Fax # | 765-284-7122 |
| Email: | lyc_nci@sbcglobal.net |