40
Backflow stops and Cleaning pipes Triplex
Handover record
7 Handover record
Commissioning and induction by the company performing the work in the presence of the
owner or his responsible representative.
Date of commissioning:
Date of handover:
Product identification
Product
Art.-no.
Section 2.2
Serien-no.
type plate
Nominal width
[DN]
Cleaning pipe
50
75
100
125
150
Single backflow stop (type 0)
Single backflow stop (type 1)
Double backflow stop (type 2)
Technical supervisors
Work performed
by
Work accepted
by
Owner
Name:
Contact:
Tel.:
Fax:
e-mail:
Address: