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Armoire de commande pour Évaporateur de chlore C 6100
12 Déclaration de non-opposition
Copiez cette déclaration, apposez-la à l'extérieur de l'emballage et envoyez-la avec l'appareil !
Declaration of no objection
Please fill out a separate form for each appliance!
We forward the following device for repairs:
Device and device type: ................................................................
Order No.:.....................................................................................
Reason for repair: ......................................................................................................................................................................................
..................................................................................................................................................................................................................
..................................................................................................................................................................................................................
Dosing medium
Description: ..................................................................................
Properties: ....................................................................................
We hereby certify, that the product has been cleaned thoroughly inside and outside before returning, that it is free from hazardous
material (i.e. chemical, biological, toxic, flammable, and radioactive material) and that the lubricant has been drained.
If the manufacturer finds it necessary to carry out further cleaning work, we accept the charge will be made to us.
We assure that the aforementioned information is correct and complete and that the unit is dispatched according to the legal
requirements.
Company / address:......................................................................
.....................................................................................................
.....................................................................................................
Customer No.:...............................................................................
Date, Signature:............................................................................
Déclaration de non-opposition
20
Sorties d'alarme
Part-no.:...................................................................................
Date of delivery: .......................................................................
Irritating:
Yes
Corrosive:
Yes
Phone:......................................................................................
Fax:..........................................................................................
Email:.......................................................................................
Contact person: ........................................................................
BA-20502-03-V06
Instructions de service
No
No
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