Lutz-Jesco C 2526, Operating Instructions Manual

Page: 43 / 48

Declaration of no objection
43
© Lutz-Jesco GmbH 2016
Subject to technical changes.
160520 BA-20901-02-V01
Chlorinator C 2526 Operating instructions
16 Declaration of no objection
Please copy the declaration, stick it to the outside of the packaging and return it with the device.
Declaration of no objection
Please fill out a separate form for each appliance!
We forward the following device for repairs:
Device and device type: ................................................................ Part-no.:...................................................................................
Order No.:..................................................................................... Date of delivery: .......................................................................
Reason for repair: ......................................................................................................................................................................................
..................................................................................................................................................................................................................
..................................................................................................................................................................................................................
Dosing medium
Description: .................................................................................. Irritating:

Yes

No
Properties: .................................................................................... Corrosive:

Yes

No
We hereby certify, that the product has been cleaned thoroughly inside and outside before returning, that it is free from hazardous
material (i.e. chemical, biological, toxic, flammable, and radioactive material) and that the lubricant has been drained.
If the manufacturer finds it necessary to carry out further cleaning work, we accept the charge will be made to us.
We assure that the aforementioned information is correct and complete and that the unit is dispatched according to the legal
requirements.
Company / address:...................................................................... Phone:......................................................................................
..................................................................................................... Fax:..........................................................................................
..................................................................................................... Email:.......................................................................................
Customer No.:............................................................................... Contact person:........................................................................
Date, Signature:............................................................................