Homa TCV 409 Series, Original Instruction Manual

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16
14. Order Sheet for Spare Parts
To:
HOMA Pumpenfabrik GmbH
D – 53819 Neunkirchen-Seelscheid
Fax: ++49 / 22 47 / 7 02 44
Pump type
(see pump label)
:
Year of construction
(see pump label)
:
Position number of the spare part:
1)
2)
3)
4)
Part description of the spare part:
1)
2)
3)
4)
Required Quantity:
1)
2)
3)
4)
Delivery adress:
Signature / Company stamp