OSHA Form 5-30-7 NRTL Initial Application and Expansion Test Worksheet

NRTL Initial Application and Expansion Test Standard Worksheet					OMB No. 1218-0147 / Expires: xx/xx/xxxx
Part I: General Information
1. Test Standard Designation:		2. Test Standard Title:
3. Year of Issue or Revision:		4. Approved By (ANSI, ISA, ASTM, etc.):
5. Name of Laboratory Test Site:
6. Laboratory Test Site Physical Address
a. Street Address:
b. City:			c. State/Province (as applicable):				d. Postal Code:
Part II: Test Equipment
7. For each item below, identify special requirements / considerations when capturing test data
a. Test Standard Clause(s)	b. Type Test or Measurement			c. Equipment Name and Model Number
Part III: Test Procedure
8. For each item below, identify special requirements / considerations when capturing test data
a. Test Standard Clause(s)	b. Laboratory Test Procedures					c. Procedures in Place?
						Yes No
						Yes No
						Yes No
						Yes No
						Yes No
						Yes No
						Yes No

Part IV: Test Data Recording Approach (Data Sheets)
9. Describe approach for recording test data:
10. For each item below, identify the test clauses covered and the name (or filename) of the corresponding datasheet
a. Test Standard Clause(s)	b. Name of Test Datasheet and Datasheet Item (datasheet title or filename as appropriate)
11. For each item below, identify special requirements / considerations when capturing test data
a. Test Standard Clause(s)	b. Special Requirements / Considerations
Part V: Special Apparatus or Facilities
12. For each item below, identify special requirements / considerations when capturing test data
a. Test Standard Clause(s)	b. Laboratory Test Procedures	c. Facilities in Place?
		Yes No
		Yes No
		Yes No
		Yes No
		Yes No
		Yes No
		Yes No

Part VI: Program Integration and Plan Validation
13. How will this test standard be integrated into the laboratories training and qualification system?
14. How will this test standard be integrated into the applicant’s factory surveillance program?
15. Number of products currently evaluated under this standard.
16. Number of products currently listed under this standard.
17. Approved By (type or print name):
18. Signature:		19. Date:

Part VII: Comparability Analysis Matrix (optional)
13. For each item below, identify special requirements / considerations when capturing test data
a. Comparable Standard	b. Clause	c. Requirement	d. Significant Difference	e. Information NRTLs need to submit

Paperwork Reduction Act Statement		OMB Control Number: 1218-0147
According to the Paperwork Reduction Act of 1995, no person is required to respond to a collection of information unless such collection displays a valid OMB control number. Public reporting burden for this collection of information is estimated to average 2 hours for each test standard. This burden includes locating and assembling information required to complete the application and is included in the burden calculated for initial applications and expansions. The obligation to respond to this collection is voluntary. Information obtained from this form will be used to determine if the application and supporting information meets the requirements of the NRTL Program as outlined in 29 CFR 1910.7. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Labor, OSHA, Office of Technical Programs and Coordination Activities, Directorate of Technical Support and Emergency Management, 200 Constitution Avenue, NW, Room N3655, Washington, DC 20210.
Form Completion Directions
General Guidance
OSHA safety standards require that specified equipment and materials (products) be tested and certified for safety by an OSHA-recognized organization. OSHA’s Nationally Recognized Testing Laboratory (NRTL) Program fulfills this responsibility by recognizing the capabilities of mainly private sector testing organizations to test and certify such products for manufacturers. To be recognized, an organization must meet OSHA’s requirements. Initial recognition is granted if the application and an on-site audit of the organization demonstrate the applicant is completely has the capability to test and certify products for safety. An organization must have the necessary capability both as a testing laboratory and as a product certification body to receive OSHA recognition as an NRTL. Once recognized, OSHA reviews each NRTL’s activities to assure it continues to comply. The NRTL can also request an expansion of its recognition. This form, and its attachments, asks the NRTL to verify its general information as well as provide specific information related to its facilities and capabilities to meet NRTL Program requirements. Completing this form is entirely voluntary. Each applicant is free to submit an application for initial recognition or expansion using any form it chooses. However, OSHA will consider applications that do not contain the information requested in this form to be deficient and may delay or deny the request. An applicant that chooses to use this form for initial recognition or expansion must send: (1) this completed form; (2) any additional information it wishes to submit to demonstrate capabilities to meet NRTL Program requirements; and (3) payment to: Director Office of Technical Programs and Coordination Activities Directorate of Technical Support and Emergency Management Occupational Safety and Health Administration US Department of Labor 200 Constitution Avenue NW, Room N3655 Washington, DC 20210 Completed and signed forms and any accompanying documentation may also be scanned and emailed to [email protected]. For questions, contact the Office of Technical Programs and Coordination Activities at +1.202.693.2110
Part I Directions
Part I of this form provides basic information related to the test standard. The information will be used to determine if the standard is appropriate and the. Complete each bock as indicated below.
Block 1:	Enter the designation for the requested test standard (e.g. UL 2305).
Block 2:	Enter the full title for the requested test standard (e.g. Exhibition Display Units, Fabrication, and Installation).
Block 3:	Enter the year the test standard was recognized or revised by the standard development organization.
Block 4:	Enter the name of the standards development organization that developed and approved the test standard
Block 5:	Enter the name of the test site that is currently recognized or requested where this testing will be conducted. If more than one test site, list the primary test site or company headquarters.
Block 6:	Enter the physical street address, city, state, and postal code for the headquarters office of the applicant. For international addresses, enter the province followed by the country name in Block 6c.
Part II Directions
Please identify the test equipment owned by the applicant that will be used to meet the requirements outlined in the requested test standard.
Block 7:	Block 7a. Enter the clause(s) in the test standard that require the use of the test equipment. Block 7b. Enter the type of measurement the test equipment will be used for in relation to the clause identified in Block 7a. Block 7c. Enter the name and model number of the test equipment used to take the measurement defined in Block 7b.
Part III Directions
Please enter test clauses associated with the requested test standard that require special consideration or special requirements when capturing test data. Identification of special requirements will facilitate the analysis of newly identified test standards.
Block 8:	Block 8a. Enter the clause(s) in the test standard that contain special requirements and / or consideration. Block 8b. Enter the procedure the applicant proposes to use to address the special requirements and / or consideration as outlined in the clause identified in Block 8a. Block 8c. Check Yes or No to verify if the procedure defined in Block 8b is currently in place at the applicant test site.
Part IV Directions
Please enter the approach to meeting the requirements for capturing and recording test data defined in the test standard.
Block 9:	Provide a detailed description of the approach the applicant intends to use to capture and record test data. Include any test datasheets associated with this test standard with the applicant’s submission.
Block 10	Block 10a. Enter the clause(s) in the test standard that contain specific data collection requirements.
Part IV Directions (continued)
Block 10 (continued)	Block 10b. Enter the name of the datasheet and the item number used to capture this information. If using an alternate data collection procedure, identify the procedure clause that describes how the test data for the clause(s) identified in Block 10a.
Block 11.	Block 11a. Enter the clause(s) in the test standard that contain special requirements and / or consideration when capturing and recording test data. Block 11b. Enter the procedure the applicant proposes to use to address the special requirements and / or consideration as outlined in the clause identified in Block 11a.
Part V Directions
Please enter the special facilities or apparatus that is required to conduct the test for which the applicant applied.
Block 12	Block 12a. Enter the clause(s) in the test standard that have requirements for special facilities or apparatus. Block 12b. Enter the procedure the applicant proposes to use to address the required special facility and / or apparatus outlined in the clause identified in Block 12a. Block 12c. Check Yes or No to verify if the facilities and /or apparatus defined in Block 12b is currently in place at the applicant test site.
Part VI Directions
Please enter the special facilities or apparatus that is required to conduct the test for which the applicant applied.
Block 13	Provide a description of how the requirements of the proposed test procedures will be integrated into the organization’s training and qualification programs.
Block 14	Provide a description of how the requirements of the proposed test procedures will be integrated into the organization’s factory surveillance programs.
Block 15	Enter the number of products currently tested by the applicant under this standard (includes testing conducted outside the NRTL Program).
Block 16	Enter the number of products currently listed by the applicant under this standard (includes testing conducted outside the NRTL Program).
Block 17	Type or print the name of the individual that approved the test standard for incorporation into the applicants testing and certification program (the test standard technical point of contact for the applicant).
Block 18	Place the signature of the individual identified in Block 17.
Block 19	Enter the date the individual identified in Block 17 signed the worksheet.
Part VII Directions
Part VII provides an alternative method for validating an NRTL has the requisite capabilities to meet the requirements to conduct a test in accordance with the specifications outlined in the requested test standard. Part VII relies on comparing the currently recognized capabilities of an NRTL with comparable requirements outlined in the requested test standard. Part VII can be used to identify similarities in capabilities and differences. In identifying differences in capabilities, the NRTL need only demonstrate how these differences will be addressed in their operations. Because Part VII relies on currently recognized capabilities, it is not available for use by new initial applicants.
Block 13	Block 13a. Enter the name of the comparable test standard. Block 13b. Enter the clause(s) in the test standard listed in Block 13a the defines comparable requirements to a requirement in the requested test standard. Block 13c. Enter a description of the requirements outlined in the test standard listed in Block 13a and how these requirements compare to those outlined in the requested test standard. Include the specific clauses in the requested test standard when defining the comparable requirements. Block 13d. Enter a description of the significant differences, if any, between the requirements outlined in the test standard listed in Block 13a and those outlined in the requested test standard Block 13e. Enter any additional information the NRTL would need to include to demonstrate their capabilities in being able to perform the requirements identified in Block 13d.

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OSHA Form 5-30.7 October 2013