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LITHIUM

BAT TERY

SERVICE

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Page 1

Version 2/2019 © This form was provided by www.lithium-battery-service.com

LITHIUM BATTERY TEST SUMMARY AND SUPPLIER INQUIRY

IN ACCORDANCE WITH SUB-SECTION 38.3

OF MANUAL OF TESTS AND CRITERIA

1. Name/Description of battery

1a. Name/Description of the cells inside the battery

The test summary of the cells inside the battery must either be presented or under checkpoint 9 and 9a it must

be conﬁrmed that the UN 38.3 test summary for the cells is available.

2. Manufacturer of battery

Name

Address

Phone

Website

2a. Manufacturer of the equipment (if the battery is contained in equipment)

Name

Address

Phone

Website

3. Test laboratory of battery

Name

Address

Phone

Website

4. ID-number and date

Unique test report identiﬁcation number Date of test report

N/A = Not Applicable

Part no. 215617-01

Company confidential

ATS Electronic Technology Co., Ltd.

3/F, Building A, No. 1 Hedong Three Road, Jinxia Community, Changan, Dongguan,

+86-769-38975958

www.dgats.com

ATSU190710611

2019August6

1 cell

Plantronics Inc. dba Poly

345 Encinal Street, Santa Cruz, California USA 95060

800-544-4660 or 831-426-5858

poly.com/us/en

Summary of content (4 pages)

PAGE 1
LITHIUM BATTERY TEST SUMMARY AND SUPPLIER INQUIRY IN ACCORDANCE WITH SUB-SECTION 38.3 OF MANUAL OF TESTS AND CRITERIA N/A = Not Applicable 1. Name/Description of battery Part no. 215617-01 1a. Name/Description of the cells inside the battery 1 cell The test summary of the cells inside the battery must either be presented or under checkpoint 9 and 9a it must be confirmed that the UN 38.3 test summary for the cells is available. 2.
PAGE 2
LITHIUM BATTERY TEST SUMMARY AND SUPPLIER INQUIRY IN ACCORDANCE WITH SUB-SECTION 38.3 OF MANUAL OF TESTS AND CRITERIA Name/Description of battery (taken from field 1) Part no. 215617-01 DESCRIPTION OF BATTERY 5. Mark the type of battery with an ” ” Lithium ion battery Lithium metal battery Lithium hybrid battery 6. Parameters Mass in gram (g): 11.14 Lithium ion: Indicate watt-hour rating (Wh): 2.
PAGE 3
LITHIUM BATTERY TEST SUMMARY AND SUPPLIER INQUIRY IN ACCORDANCE WITH SUB-SECTION 38.3 OF MANUAL OF TESTS AND CRITERIA Name/Description of battery (taken from field 1) Part no. 215617-01 9a. UN 38.3 Test Confirmation for the Cells inside the battery When no separate document for the cells is provided, this confirms that the cells inside the battery (see checkpoint 1.a.) have successfully passed the UN 38.3 test. In this case under checkpoint 9 the T.6 and T.8 must be marked as „passed“ and here under 9.a.
PAGE 4
LITHIUM BATTERY TEST SUMMARY AND SUPPLIER INQUIRY IN ACCORDANCE WITH SUB-SECTION 38.3 OF MANUAL OF TESTS AND CRITERIA Name/Description of battery (taken from field 1) Part no. 215617-01 BATTERIES INSTALLED IN EQUIPMENT 18. Check point 18 needs to be answered when the batteries are installed in articles: 18.a) Only button cells enclosed? YES NO 1 18.b) Number of enclosed batteries per equipment When the equipment is intentionally active/switched on during transport e.g. data loggers: 18.