17 Declaration of media in contact
with the micro annular gear pump and its components
Operating manual mzr-2961, mzr-4661
Last update: April 2018
Technical data subject to change without prior notice!
51
17
Declaration of media in contact
with the micro annular gear pump and its components
Type of the device
Pump type/serial number/article no.:
Operating hours/running time:
Number of delivery note or delivery date:
Reason of return:
Contact with media (liquids)
The micro annular gear pump was in contact with:
and has been rinsed with:
Product info sheet / Material Safety Data Sheet:
yes*
no
* Please attach file
or is available on the following web site:
www.
If a pump which had contact with dangerous substances could not be properly cleansed prior to shipment,
we reserve the right to entrust a specialized company with cleansing of the device. The return of the pump
in original packing is advisable. It is necessary in order to protect the employees and delivery staff.
Nature of media contact:
explosive
toxic
(
toxic byproducts
)
carcinogenic
irritant
oxidizing
radioactive
microbiological
corrosive
sensitive to moisture
pH-
value
:
approx
.
to
other:
R-statements:
S-statements:
Declaration
Hereby I/we affirm that the stated information is complete and correct. Micro annular gear pump and
accessories are shipped in conformity with the applicable regulations.
company:
division:
street, no.:
ZIP/city:
country:
city, date:
Mrs
Mr
title:
name:
phone:
e-mail:
authorized signature /
company stamp:
