Certificate of non-objection
57
BA.10A.CNY.001.01.10.GB
7. Certificate of non-objection
7.1 Certificate of non-objection
The following pump and its accessories, together with this
certificate of non-objection, are herewith contracted out by the
undersigned for inspection/repair:
Pump data
•
Model:
•
No.:
•
Delivery Date:
Reason for inspection / repair contract:
________________________________________________
________________________________________________
________________________________________________
________________________________________________
The pump (please mark with a cross)
___ was not used in media hazardous to health
___ was used for the following: _______________________
Please state the last medium to be pumped, if known:
________________________________________________
The pump was carefully drained and also cleaned inside and
out before it was shipped/made available. (please mark with
a cross)
___ No special safety measures are required in the course of
further handling.
___ The following safety measures pertaining to flushing me-
dia, residual liquids, and disposal are required:
________________________________________________
________________________________________________
________________________________________________
________________________________________________
We confirm that the information given above is correct and
complete and that shipment is in compliance with legal regu-
lations.
Overview
This section contains a certificate of non-objection. In case of inspection or repairing send the pump including
these certificate to HILGE.
Company (address):
Telephone, fax, email
Name (please print), title
Date
Company stamp / signature