04/2013
2.990.999.120_en
53
SP 5080
7.1 Disposal
verifi cation form
To
HSM
GmbH + Co. KG
Austraße 1 - 9
D-88699 Frickingen / Germany
The machine specifi ed here
Designation:
Baling press / Shredder
Model:
Machine number:
Year of construction:
has been disposed of according the applicable regulations.
Address of the last
operating company
Address of the
waste management company
............................................... ...............................................
Date
and
signature
Date
and
signature
of the last operator
of the disposal company