Declaration of no objection
When sending for repair, please copy, fill out and send along with each device.
Declaration of no objection - Form
(please fill out one form for each device and attach it to the outside of the device)
We are returning the following device for repair:
Device and device type: .............................................................................................................
Part No.: ...................................................................................................................................
Order No.: ................................................................................................................................
Date of delivery: ........................................................................................................................
Reason for repair: .....................................................................................................................
Medium conveyed:
Description: ...............................................................................................................................
Properties: .................................................................................................................................
Irritant:
Yes/No*)
Corrosive:
Yes/No*)
*) Please delete as appropriate.
We hereby certify that the product has been cleaned thoroughly on the inside and outside before
shipment, that it is free from hazardous chemical, biological, or radioactive materials and that the oil
has been drained. *)
If the manufacturer finds it necessary to carry out further cleaning work, we will accept the related
costs.
We confirm that the above statements are correct and complete and that the device is being shipped
according to the legal requirements.
Company: ..................................................................................................................................
Address: ....................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
Phone: ......................................................................................................................................
Fax: ...........................................................................................................................................
E-mail: ......................................................................................................................................
Customer No.: ...........................................................................................................................
Contact person: .........................................................................................................................
Date, signature, stamp: ..............................................................................................................
Declaration of no objection | Operation & Maintenance Instructions |
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Summary of Contents for MEMDOS E
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