Grundfos CMV 3 Notice D'installation Et De Fonctionnement page 13

Annexe
Please copy, fill in and sign this sheet and attach it to the pump returned for service.
Which media has the pump been used for: ______________________
In which application has the pump been used: ____________________
Please give a short description of the fault:
We hereby declare that this product is free from hazardous chemicals,
biological and radioactive substances.
_________________________
Date and signature
Safety declaration
Media and application
Fault description
If possible please make a circle around the faulty part.
(In case of an electrical fault, please mark the terminal box.)
_________________________
Company stamp
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