Agilent Technologies G8610 Series, Инструкции по установке на месте

Страница: 35 / 36

Vacuum Products Division
Instructions for returning products
Page 3 of 3
Customer Information
Customer Information Customer Information
Customer Information
Company: Contact Name:
Address: Tel: Fax:
Email:
Equipment Equipment Equipment Equipment
Product Description: Agilent Part No.: Agilent Serial No.: Original Purchasing
Reference:
Failure Description: Type of Process (for which the equipment was used)
Type of Return Type of Return Type of Return Type of Return
☐
Non-billable
☐
Billable New PO # (Hard copy must be submitted with this form): _______________
☐ Exchange ☐ Repair ☐ Upgrade ☐ Consignment/Demo ☐ Calibration ☐ Evaluation ☐ Return for Credit
Health and safety Health and safety Health and safety Health and safety
The product has been exposed to the following substances:
(by selecting ‘YES’ you MUST complete the table to the right)
Substances Substances Substances Substances (please refer to MSDS forms)
* Agilent will not accept delivery of any product that is exposed to radioactive,
biological, explosive substances or dioxins, PCB’s without written evidence of
decontamination.
Trade Name Chemical Name Chemical Symbol CAS Number
Toxic
☐
YES
☐
NO
Harmful
☐
YES
☐
NO
Corrosive
☐
YES
☐
NO
Reactive
☐
YES
☐
NO
Flammable
☐
YES
☐
NO
Explosive ( * )
☐
YES
☐
NO
Radioactive (
*
)
☐
YES
☐
NO
Biological ( * )
☐
YES
☐
NO
Oxidizing
☐
YES
☐
NO
Sensitive
☐
YES
☐
NO
Other Dangerous Substance
☐
YES
☐
NO
Goods Preparation Goods Preparation Goods Preparation Goods Preparation
If you have replied YES to one of the above questions. Has the product been purged?
☐
YES
☐
NO
If yes, which cleaning agent/method:
Has the product been drained from oil?
☐
YES
☐
NO
☐
NOT APPLICABLE
I confirm to place this declaration on the outside of the shipping box.
I declare that the above information is true and complete to the best of my I declare that the above information is true and complete to the best of my I declare that the above information is true and complete to the best of my I declare that the above information is true and complete to the best of my knowledge and belief. knowledge and belief. knowledge and belief. knowledge and belief.
I understand and agree to the terms and conditions on page 2 of this document. I understand and agree to the terms and conditions on page 2 of this document. I understand and agree to the terms and conditions on page 2 of this document. I understand and agree to the terms and conditions on page 2 of this document.
Name: Authorized Signature:
Position:
Date:
NOTE
NOTE NOTE
NOTE : If a product is received at Agilent which is contaminated with a toxic or hazardous material that was not disclosed, the
the the
the
customer will be held responsible customer will be held responsible customer will be held responsible customer will be held responsible for all costs incurred to ensure the safe handling of the product, and is liable for any harm or injury
to Agilent employees as well as to any third party occurring as a result of exposure to toxic or hazardous materials present in the
product.