Operating
Instructions
05/2011
1096.0833 | CY, CSY, LNY, LSY, NPY, PY, Y, YS Series
57
10.2 Certificate of conformity
Please copy this form and return it to the manufacturer together with the pump/aggregate.
Certificate of conformity
The pump/pump aggregate including accessories for which we, the undersigned, have placed an inspection/repair order or which has
been returned by us together with this certificate of conformity,
Designation:
Type:
Serial number:
has not been in contact with hazardous substances.
has been used in the
area of application of:
and has been in contact with the following harmful substances or substances subject to mandatory labelling:
Trade name
Chemical designation
Properties
(e.g. toxic, inflammable, caustic)
The pump/pump aggregate has been completely drained, flushed and cleaned both inside and outside in accordance with the
operating instructions.
Further handling of the pump/aggregate does not require special safety precautions.
The following safety precautions must be observed when handling the pump/aggregate:
Safety data sheets in accordance with national regulations are enclosed.
Legally binding statement
We herewith certify that all data given above are correct and complete and that I, the undersigned, am in a position to confirm this.
We acknowledge our liability towards the contractor for any damage arising from incomplete or incorrect data.
We agree to hold harmless the contractor against damage claims of third parties due to incomplete or incorrect data.
We know that, independent of this statement, we have to take direct liability towards third parties, which particularly refers to the staff
of the contractor responsible for handling, repair and maintenance.
City, date:
Name:
Company
stamp:
Signature:
Tab. 61 Certificate of conformity
