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UNDERWRITERS LABORATORIES INC.

INSPECTION REPORT - Type R Service


E18634610411241052

Date Responsible Office Inspection Center CCN Product Category

11/24/2004 Northbrook 732 QCIT METALLIC OUTLET BOXES

File Number Volume Account / Order Number UL Rep Name UL Representative ID Factory Representative: Factory Rep Phone

E186346 1 R60885 Nelson Simoes 55013 German Buj 5554 461 8200

Subscriber - Factory 239522-001 Number Manufacturer Name FORJASUL ELETRIK S A Manufacturer AddressRODOVIA RS 446 KM 17 95185-000 BAIRRO TRIANGULO CARLOS BARBOSA BRAZIL

Nature of Visit

Regular Inspection Yes

Listing/Classification/Recognized (Unlisted) Component Marks Used Since Last Visit Listing/Classification/Recognized (Unlisted) Component Marks Removed

Yes Yes

Variation Notice Issued


Data Sheets Sent Comments After Submission

Yes

PRODUCTS EXAMINED
Model 5603/52 5604/53 5606/51 Product Outlet Box Outlet Box Outlet Box Class Section/ RRN 1 1 1 Multiple Listed No No No

If samples are required to be sent to ULI Laboratory, indicate below. If required samples are not sent, explain in the Comments area.

SAMPLE DOCUMENTS
Type, Style, Cat, Model Name Sample Tag Number Shipped to Office

No Samples
Time in Factory: Additional Comments: 2.00

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