Grundfos DMX 221 Notice D'installation Et De Fonctionnement page 75

B.1. Safety declaration
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Fault description
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Declaration
We hereby declare that this product is free from hazardous chemicals, biological and radioactive
substances (see pump nameplate):
Type designation:
Product number:
The product was used with the following dosing medium:
No dosing medium or water:
A chemical solution, name:
Date and signature:
Company stamp:
Please copy, fill in and sign this sheet and attach it to the pump returned for service.
Fill in this document using English or German language.
Please make a circle around the damaged part.
In the case of an electrical or functional fault, please mark the cabinet.
Please give a short description of the fault:
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