M (E2) 04/2019
page 70/71
Customer (End User) Decontamination Declaration
Health and Hazard Safety declaration
To protect the health of our employees and the safety at the workplace, we require that this form is com-
pleted by the user for all products and parts that are returned to us. (Distributors or Service Organizations
cannot sign this form)
NO RMA number will be issued without a completed form. Products or parts returned to our
NY warehouse without a RMA number will be refused at the dock.
A second copy of the completed form must be attached to the outside of the shipping box.
1.
Unit/ component part / type
:
2.
Serial No.
3.
List any exposure to hazardous liquids, gasses or substances and radioactive material
3.1
List with MSDS sheets attached where available or needed
(if there is not enough space available below, please attach a page):
a)
____________________________________________________________________________
b)
____________________________________________________________________________
c)
____________________________________________________________________________
3.2
Safety measures required for handling the list under 3.1
a)
____________________________________________________________________________
b)
____________________________________________________________________________
c)
____________________________________________________________________________
3.3
Measures to be taken in case of skin contact or release into the atmosphere
:
a)
____________________________________________________________________________
b)
____________________________________________________________________________
c)
____________________________________________________________________________
d)
____________________________________________________________________________
3.4
Other important information that must be considered
:
a)
____________________________________________________________________________
b)
____________________________________________________________________________
c)
____________________________________________________________________________
Summary of Contents for M 115
Page 58: ...M E2 04 2019 page 58 71 15 7 Dimensions M 53...
Page 59: ...M E2 04 2019 page 59 71 15 8 Dimensions M 115...
Page 60: ...M E2 04 2019 page 60 71 15 9 Dimensions M 240...
Page 61: ...M E2 04 2019 page 61 71 15 10 Dimensions M 400...
Page 62: ...M E2 04 2019 page 62 71 15 11 Dimensions M 720...
Page 63: ...M E2 04 2019 page 63 71 16 EU Declaration of Conformity...
Page 64: ...M E2 04 2019 page 64 71...
Page 65: ...M E2 04 2019 page 65 71 17 Product registration...
