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    MSA Declaration of Conformity: SCP-Z06 Tab SCP-Z04 Rev 2 Page 1 of 2

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    MSA Declaration of Conformity: SCP-Z06 Tab SCP-Z04 Rev 2 Page 1 of 2

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    Msa

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    MSA Declaration of Conformity: SCP-Z06 Tab SCP-Z04 Rev 2 Page 1 of 2

    Uploaded by

    victorfernandez2030

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    © All Rights Reserved
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    of 2

    1000 Cranberry Woods Drive,

    Cranberry Township, PA 16066

    MSA Declaration of Conformity


    In Accordance with ANSI/ASSP Z359.7-2019
    IAC-23-081 - Z04 Rev 1

    Statement of Conformity: MSA declares that the


    Anchorage Connector Strap (Web)
    is in conformity with the requirements of
    ANSI Z359.18-2017

    Product Code Model / Part Numbers Covered

    240673, 185929, 505314, 10001621, 10002183, 10002562, 10002658, 10003122, 10005410,


    10012858, 10023490, 10032534, 10036028, 10037533, 10038457, 10069692, 10069693,
    SFP2267506 10071670, 10071852, 10073760, 10076097, 10077603, 10094075, 10096311, 10097035,
    10099896, 10121034, 10126008
    10023487

    ANSI/ISEA 125-2014 conformity assessment method: Level 1 X Level 2

    For Level 2, information about ISO 17025-accredited facility in which the product was tested:

    The test facility is an independent 3rd Party ISO 17025-accredited facility


    ISO Accrediting Agency:

    The test facility is owned or partially owned by an entity within supplier’s corporate structure, or
    X within the manufacturing stream for this product, including subcontractors and sub-suppliers.

    ISO Accrediting Agency: ANAB ANSI National Accreditation Board

    Report Test Facility Used: Test Facility Document #


    1 FPLab FPLAB-94-01

    For additional information about this product(s), please contact MSA Customer Service at 1-800-
    MSA-2222. When requesting information, please reference model number(s).

    2026
    QA Rep: Brooke Conroy Date: MM/DD/YYYY

    2026
    Qualified Person: Tim Botti Date:
    MM/DD/YYYY

    SCP-Z06 Tab SCP-Z04 Rev 2 Page 1 of 2


    Performance Details
    Revision 1

    Pass /
    Report Standard and Product Requirements Acceptance Criteria
    Fail
    Anchorage connector shall be capable of
    1 3.2.1.1 (4.2.1.1) Static Strength - Type A resisting a static load of at least 5000lbs Pass
    (22.2kN) for at least 3 minutes
    Drop 282lbs (128kg) test weight from a
    1 3.2.2.1 (4.2.2.1) Dynamic Strength - Type A Pass
    height of 3ft (0.9m)
    Using same anchorage connector that was
    tested to 3.2.2.1 (4.2.2.1), repeat the drop
    1 3.2.3.1 (4.2.3.1) Residual Strength - Type A test portion. Anchorage connector shall Pass
    arrest and hold the weight for an additional
    minute

    Revision Date Project Engineer Qualified Person


    0 1/16/2020 Mike Monahan Mike Monahan
    1 2/22/2023 Tim Botti Tim Botti

    SCP-Z06 Tab SCP-Z04 Rev 2 Page 2 of 2

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