Test Site Services. Inc.

1 EMC001677-NEEMC000142-NEReg. No. R700 Reg. No. C719 BSMI Lab No. 99-106 Lab Code 100419-0 Test site services . Test ReportYour Company NameYour ProductModel X-100 Radiated and Conducted EmissionsFCC, Part 15 BCanada, ICES-003AS/NZS 3548 VCCI (Japan)BCIQ, CNS 13438 EMC Directive, 89/336/EECTest # B00999 Test site services , Box 766 Marlboro, MA : (508) 481-1684 This report shall not be reproduced, in whole or in part without the written approval of Test site services report must not be used by the recipient to claim product endorsement by NVLAP or any other agency of the GovernmentTest site services , # B00999 Your Company Name1/22/00 EUT.

2 Your ProductTable of ContentsGENERAL UNDER TEST DIAGRAM OF EQUIPMENT A, TEST B, TEST C, TEST D, MEASUREMENT FACILITIES site services , # B00999page 1 of 19 Your Company Name1/22/00 EUT: Your ProductEMI Test ReportforYour Company NameTest Number: B00999 Product Name: Your ProductRegulation: FCC, Part 15B ( ): ICES-003 (Canada): AS/NZS 3548: VCCI (Japan): BCIQ / CNS 13438: EMC Directive, 89/336/EECDate: 1/22/00 report Reviewed& Accepted by: Your Company Name2000 Maple StreetSpringville, NN 99999-3333 Phone: (123) 456-7890 Fax : (123) 456-7899 report Issued By: Richard L.

3 Wiedeman, Laboratory DirectorTested By: John Doe, Test EngineerThis test report is not valid without the signatures of Test site services , Inc. site services , # B00999page 2 of 19 Your Company Name1/22/00 EUT: Your ProductAdministrative DataRegulation: FCC, Part 15B ( ): ICES-003 (Canada): AS/NZS 3548 (Australia, New Zealand): VCCI (Japan): BCIQ (Taiwan): EMC Directive 89/336/EEC ( )Level: Class ATest Method: ANSI : CSA : VCCI, V3 : CNS 13438: EN55022(1994)/CISPR22(1993)Test Type: QualificationManufacturer: Your Company NameEUT Type/Model #: Widget / X-100 Date(s) of Test: 1/22/00 CustomerPersonnel: John AdamsEngineerTSS Personnel: R.

4 WiedemanEMC Engineer: John DoeTest EngineerTest Location: Open Area Test site Test site services , Inc. 30 Birch St. Milford, MA 01757 : FCC Rule requires that a Verification report for a Class A Computing Device must be signed by "an Official of the Company responsible for the device". A signature block has been provided on the first page for this site services , # B00999page 3 of 19 Your Company Name1/22/00 EUT: Your ProductEUT DescriptionThe EUT (Your Product) is a Widget that is faster than a speeding bullet, more powerful than alocomotive, and leaps tall buildings in a single complete description of the EUT may be found on block identifier page tests were run in a typical configuration including the following support equipment.

5 1)Personal Computer5)Switching Hub2)Ethernet Hub6)Modem3)Switching Hub4)Switching HubREASON FOR TESTQ ualification of new product for all international specifications for radiated and conducted MADE DURING TESTNoneDEVIATIONS FROM STANDARD TEST METHODNoneTest site services , # B00999page 4 of 19 Your Company Name1/22/00 EUT: Your ProductTest SummaryThe Your Product complied with the FCC Part 15 Subpart B and Canadian ICES-003 Limits for equipment when tested in the system configuration defined following table indicates the margins ( difference between measurementpoint and limit) of the six (6) worst case data points:TEST CLASSMARGIN TO SPEC (db)FREQUENCY (Mhz)Radiated Emissions E (230 VAC / 50 Hz.

6 Conducted (208 VAC / 60 Hz.) site services , # B00999page 5 of 19 Your Company Name1/22/00 EUT: Your ProductTest SummaryThe Your Product complied with the EN55022/CISPR22,VCCI, AS/NZS andBCIQ Limit when tested in the system configuration defined following table indicates the margins ( difference between measurementpoint and limit) of the six (6) worst case data points:TEST CLASSMARGIN TO SPEC (db)FREQUENCY (Mhz)Radiated Emissions E (230 VAC / 50 Hz.) Conducted (230 VAC / 50 Hz.) site services , # B00999page 6 of 19 Your Company Name1/22/00 EUT: Your ProductBlock Diagram for Your ProductPS = Power Cord ShieldedDS = Data Cable ShieldedCX = Coaxial CablePU = Power Cord UnshieldedDS = Data Cable ShieldedFL = Fiber Link= Ferrite Bead= Connector E2-E5(DU)Ground PlaneControl Room A1(PS) D(DS)F1(FL) F2(FL) F3(FL) C1(PU) G1(DS) F4-F5(FL) B4(PU) H1(DS) B2(PU) B3(PU) B5(PU)B1(PU)1 7 32 Monitor54 6 KeyboardTest site services , # B00999page 7 of 19 Your Company Name1/22/00 EUT.

7 Your ProductEUT Technical Data Block Identifier 1 Description: New WidgetManuf/Model: Your Company, No.: :X-100 Part#/Rev: 000-111-222 / Rev. #: 000 000 001 FCC/FTZ Ident.: N/APower (Rated): 90 240 VAC 50 / 60 : 10 / 5 AmpsPower (Tested): 230 VAC 50 : 5 AmpsInternal Options:Plug in widget # 1M/N001S/N000 in widget # 2M/N002S/N000 in widget # 3M/N003S/N000 Options:NoneFrequencies :Test site services , # B00999page 8 of 19 Your Company Name1/22/00 EUT: Your Product Support Equipment Data Block Identifier 2 Description: Personal ComputerManuf/Model: CompanyModel No.

8 : FPSPart #/Rev: 001 / Rev. #: 111 222 333 FCC/FTZ Ident.: ABC DEF 123456 Power: 100 240 VAC 50 / 60 Options:Ethernet AdapterM/N12345 AdapterM/N67890 Options:KeyboardM/N001 :Test site services , # B00999page 9 of 19 Your Company Name1/22/00 EUT: Your Product Support Equipment Data Block Identifier 3 Description: Ethernet HubManuf/Model: CompanyModel No.: 222 Part #/Rev: 000123 / Rev. #: 999 999 FCC/FTZ Ident.: N/APower: 120 VAC 60 Hz. to 12 VDCI nternal Options:NoneExternal Options:AC/DC Power AdapterM/N123S/N555 555 Frequencies :Test site services , # B00999page 10 of 19 Your Company Name1/22/00 EUT: Your ProductSupport Equipment Data Block Identifier 4 Description: Switching HubManuf/Model: CompanyModel No.

9 : 1000 Part #/Rev: 1000-000 Rev. #: 001 FCC/FTZ Ident.: :N/APower: 120 VAC 60 Options:NoneExternal Options:NoneFrequencies :Test site services , # B00999page 11 of 19 Your Company Name1/22/00 EUT: Your ProductSupport Equipment Data Block Identifier 5 Description: Switching HubManuf/Model: CompanyModel No.: 456 Part #/Rev: 789 Rev. #: 000-999 FCC/FTZ Ident.: N/APower: 120 VAC 60 Options:NoneExternal Options:NoneFrequencies :Test site services , # B00999page 12 of 19 Your Company Name1/22/00 EUT: Your ProductSupport Equipment Data Block Identifier 6 Description: Switching HubManuf/Model: CompanyModel No.

10 : 333 Part #/Rev: 111-222 Rev. #: 123456 FCC/FTZ Ident.: N/APower: 230 VAC 50 Options:NoneExternal Options:NoneFrequencies :Test site services , # B00999page 13 of 19 Your Company Name1/22/00 EUT: Your ProductSupport Equipment Data Block Identifier 7 Description: ModemManuf/Model: CompanyModel No.: 111 Part #/Rev: 222 / Rev #: 444-555 FCC/FTZ Ident.: N/APower: 120 VAC to 14 VDCI nternal Options:NoneExternal Options:AC / DC Power AdapterM/NABC-123 Generated:N/AComments:Test site services , # B00999page 14 of 19 Your Company Name1/22/00 EUT: Your ProductCable Descriptions(A1)Function:AC PowerQty = 1 Type: Meters# of Conductors:3 Connector Shell:UnshieldedPart Number:000-123 (B1-B5)Function:AC PowerQty = 5 Type: Meters# of Conductors:3 Connector Shell:UnshieldedPart Number:Miscellaneous:(C-1)Function:DC PowerQty = 1 Type: Meters# of Conductors:2 Connector Shell:UnshieldedPart Number:Miscellaneous.