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UNITED STATES
MTS Systems Corporation
Sensors Division
3001 Sheldon Drive
Cary, N.C. 27513
Phone: +1 919 677-0100
E-mail: [email protected]
GERMANY
MTS Sensor Technologie
GmbH & Co. KG
Auf dem Schüffel 9
58513 Lüdenscheid
Phone: +49 2351 9587-0
E-mail: [email protected]
ITALY
Branch Offi ce
Phone: +39 030 988 3819
E-mail: [email protected]
FRANCE
Branch Offi ce
Phone: +33 1 58 4390-28
E-mail: [email protected]
GREAT BRITAIN
Branch Offi ce
Phone: +44 79 44 15 03 00
E-mail: [email protected]
CHINA
Branch Offi ce
Phone: +86 21 6485 5800
E-mail: [email protected]
JAPAN
Branch Offi ce
Phone: +81 3 6416 1063
E-mail: [email protected]
www.mtssensors.com
MTS, Temposonics and Level Plus are registered trademarks of MTS Systems Corporation in the United States; MTS SENSORS and the MTS SENSORS logo are trademarks of MTS Systems Corporation within the
United States. These trademarks may be protected in other countries. All other trademarks are the property of their respective owners. Copyright © 2018 MTS Systems Corporation. No license of any intellectual
property rights is granted. MTS reserves the right to change the information within this document, change product designs, or withdraw products from availability for purchase without notice. Typographic and
graphics errors or omissions are unintentional and subject to correction. Visit www.mtssensors.com for the latest product information.
Reg.-No. 003095-QM08
9. Appendix
Safety Declaration
Dear Customer,
If you return one or several sensors for checking or repair, we need you to sign a safety declaration. The purpose of this declaration is to ensure
that the returned items do not contain residues of harmful substances and / or that people handling these items will not be in danger.
MTS Sensors order number: _______________________________
Serial number(s): ________________________________________
Sensor type(s): _________________________________________
Sensor length(s): ________________________________________
The sensor has been in contact with the following materials:
In the event of suspected penetration of substances into the sensor,
consult MTS Sensors to determine measures to be taken before
shipment.
Don’t specify chemical formulas.
Please include safety data sheets of the substances, if applicable.
Short description of malfunction:
Corporate information
Company: _______________________________________________
Address: _______________________________________________
_______________________________________________
Contact partner
Name: _______________________________________________
Phone: _______________________________________________
E-Mail: _______________________________________________
We hereby certify that the measuring equipment has been cleaned and neutralized.
Equipment handling is safe. Personnel exposure to health risks during transport and repair is excluded.
Date
Signature
Stamp
Tel. + 49 - 23 51- 95 87 0
Fax. + 49 - 23 51- 5 64 91
[email protected]
www.mtssensors.com
GERMANY
MTS Sensor Technologie
GmbH & Co.KG
Auf dem Schüffel 9
58513 Lüdenscheid, Germany
USA
MTS Systems Corporation
Sensors Division
3001 Sheldon Drive
Cary, N.C. 27513, USA
Tel. +1 919 677-0100
Fax +1 919 677-0200
[email protected]
www.mtssensors.com