Manual
Version
Page
DB04A
EN A1-9
PKP Prozessmesstechnik
46
6.17. Contamination statement
When returning equipment to us, please complete all sections of the following declaration. In
particular, the reason for return, in the case of contamination the nature of the residues and
the cleaning, as well as information on any possible hazards. Include this with shipment.
Device(s)
Model code:
Serial number(s):
Reason for return:
Type of contamination
Device was in contact with:
It was cleaned by us with:
To protect our employees and for general safety during transport, it is vital to clean devices
properly and to use appropriate packaging.
Can you provide further
information on the
contamination?
Inert (no hazard)
Corrosive
Caustic/acid
Must not come into contact with moisture
Oxidizing
Toxic
Other hazards: ___________________________
Legally binding declaration
We hereby confirm the correctness and completeness of the above information.
Company:
Address:
Phone:
Contact person:
e-mail address:
Date:
Signature:
