Rico Ric T40D Manuel D'instructions page 117

Fill out and return to:
(please wait for a confirmation by Rico Service)
MACHINE / PRODUCT DATA
Type of machine / Model
Cause
Description of defect
DECLARATION OF DECONTAMINATION
•
For the safety of our employees and compliance with the legal requirements during handling of substances hazardous to health
and the environment, this declaration must be filled out completely and sent for each machine / product.
•
Without said declaration filled out completely, repair cannot be carried out.
•
The declaration must be sent with the shipping documents.
1. The machine / the product
has NOT come into contact with hazardous substances. In case of repair / disposal, there is no risk to people and the
environment. Go to point 3.
has come into contact with hazardous substances. Go to point 2.
Information on contamination
2.
Type of system on which the machine is installed:
And it has come into contact with the following substances subject to the requirement of labelling or dangerous to health /
environment:
Trademark
The machine / product has been washed and cleaned on the outside. Specify the decontamination method used:
3. Legally binding declaration
The undersigned hereby declares that the details given on this form are true and complete.
APPLICANT'S DETAILS
Company name:
Street:
City:
Contact person:
E-mail / tel. no.
DESTINATION
ADDRESS
COMPLETION BY RICO CUSTOMER CARE
RMA no.
NOTES
 Druckluftanlagenbau GmbH
RIC T40D – T120D
E-mail
Serial no.
Repair Warranty
Blocked
Other:
Chemical name
Rico Druckluftanlagenbau GmbH – Willicher Strasse 22 – 47918 Toenisvorst (Germany)
Tel. +49 ( 0 ) 2151 9931 99 -
vk@rico-druckluft.com
purchase doc. no.
Repair Periodical maintenance
Noisy Motor failure
Hazardous substance class
Date
Postal
Code
Province
vk@rico-druckluft.com - www.seitenkanalverdichter.de
Characteristics (e.g. toxic,
flammable, corrosive)
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