11 Certificate of Decontamination
Type
................................................................................................................................
Order number/
Order item number
20)
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Delivery date
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Field of application:
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Fluid pumped
20)
:
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Please tick where applicable
20)
:
⃞
⃞
⃞
⃞
Radioactive
Explosive
Corrosive
Toxic
⃞
⃞
⃞
⃞
Harmful
Bio-hazardous
Highly flammable
Safe
Reason for return
20)
:
................................................................................................................................
Comments:
................................................................................................................................
................................................................................................................................
The product/accessories have been carefully drained, cleaned and decontaminated inside and outside prior to dispatch/
placing at your disposal.
We hereby declare that this product is free from hazardous chemicals, biological or radioactive substances.
On seal-less pumps, the rotor has been removed from the pump for cleaning.
⃞
No special safety precautions are required for further handling.
⃞
The following safety precautions are required for flushing fluids, fluid residues and disposal:
...............................................................................................................................................................
...............................................................................................................................................................
We confirm that the above data and information are correct and complete and that dispatch is effected in accordance with
the relevant legal provisions.
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.......................................................
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Place, date and signature
Address
Company stamp
20)
Required fields
11 Certificate of Decontamination
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