BÜCHI Labortechnik AG
Appendix | 10
Operation Manual Interface I-300 Pro
95/102
To guarantee the health and safety of our staff and to comply with the law and the
regulations for handling hazardous materials, regarding health and safety at work,
and to comply with safety regulations, health and safety requirements and require-
ments for safe disposal of waste such as chemical waste, chemical residues or sol-
vents, the form below must be fully completed and signed whenever devices or faulty
components are to be sent back to our factory.
Products or components will not be accepted if this declaration has not been
provided.
Device
Model:
Part/Device no.:
Declaration for
non-hazardous ma-
terials
We hereby assure that the products returned
have not been used in the laboratory and are new.
have not been in contact with toxic, corrosive, biologically active, explosive, ra-
dioactive or other hazardous materials.
are not contaminated. The solvents or residues of the substances pumped have
been removed.
Declaration for haz-
ardous materials
In respect of the products returned, we hereby assure that
all substances (toxic, corrosive, biologically active, explosive, radioactive or other-
wise hazardous) that have been pumped by the products or have otherwise been
in contact with the products are listed below.
the products have been cleaned, decontaminated, sterilised inside and outside
and all inlets and outlets are sealed.
List of hazardous materials that have been in contact with the products:
Chemical, material
Hazard category
Final declaration
We hereby declare that
we are fully conversant with the substances that have been in contact with the
products and have answered all questions correctly.
we have taken all measures necessary to prevent potential hazards in respect of
the products returned.
Company name or stamp:
Place, date:
Name (block letters), position
(block letters):
Signature:
