Ap
pe
nd
ix
5
Appendix
1
Safety declaration
Please copy, fill in and sign this sheet and attach it to the pump returned for service.
Fault description
Please make a circle around the damaged parts.
In the case of an electrical or functional fault, please mark the cabinet.
Please describe the error/cause of the error in brief.
We hereby declare that the pump has been cleaned and is completely free from chemical, biological and
radioactive substances.
_____________________________________
Date and signature
_____________________________________
Company stamp
Note
Fill in this document using english or
german language.
Product type (nameplate)
Model number (nameplate)
Dosing medium
TM
02 89
57 031
5
Dosing liquid has possibly entered the pump housing.
The pump must not be connected to the power supply! Danger of explosion!
