Walinga Ultra-Vac 6614D, Operator'S Manual

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WALINGA
Start-up/Commissioning Form
Effective: September 10, 2020
Version 1
It is the responsibility of the Owner Operator to review and determine compliance to local and federal regulations.
These regulations include, but are not limited to, local and federal laws as well as standards published by the NFPA
(National Fire Protection Agency), ISO (International Organization for Standardization), OSHA (Occupational Safety
and Health Administration) or OH&S (Occupational Health and Safety Standards), and ANSI (American National
Standards Institute).
Please note: It is a requirement in NFPA 652 that the final operator completes a dust hazard
analysis (DHA) of their facility and the products and processes it contains. Based on this, Walinga understands that a
DHA is required to be completed by the owner/operator prior to start-up/commissioning. In the event that a DHA is not
available at start-up/commissioning, the owner/operator must provide written acknowledgement of their responsibility
and intention to complete a DHA. The owner/operator also agrees that they shall be solely responsible for ensuring that
any applicable NFPA standards and regulations shall be satisfied in conjunction with the incorporation of Walinga’s
equipment into the buyer’s specific system of operations.
Date:_____________ Owner Operator’s Signature:_______________________________________
The above equipment has been received by me and I confirm that the sales representative / dealer has
completed the start-up/commissioning process.
Date:_____________ Owner Operator’s Signature:_______________________________________
I have completed the actions listed above and confirm that the owner operator has completed the start-
up/commissioning process.
Date:_____________ Dealer Representative’s Signature:___________________________________
I have completed the actions listed above and confirm that the owner operator has completed the start-
up/commissioning process.
Date:_____________ Manufacturer Representative’s Signature:______________________________
Additional notes: