Appendix
29
Appendix
1
Safety declaration
Please copy, fill in and sign this sheet and attach it to the pump returned for service.
We hereby declare that this product is free from hazardous chemicals,
biological and radioactive substances:
Product type: ________________________________
Model number: _____________________________
No media or water: _____________________________
A chemical solution, name: _________________________
(see pump nameplate)
Fault description
Please make a circle around the damaged part.
In the case of an electrical or functional fault, please mark the cabinet.
Please give a short description of the fault:
_____________________
_____________________
Date and signature
Company stamp
Note
Fill in this document using English or German language.
Gr
A3
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