11 Certificate of Decontamination
34 of 36
BOA-Control/ BOA‑Control IMS
11 Certificate of Decontamination
Type:
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Order number/
Order item number
15)
:
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Delivery date:
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Field of application:
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Fluid handled
15)
:
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Please tick where applicable
15)
:
⃞
⃞
⃞
⃞
Radioactive
Explosive
Corrosive
Toxic
⃞
⃞
⃞
⃞
Harmful
Bio-hazardous
Highly flammable
Safe
Reason for return
15)
:
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Comments:
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The product/accessories have been carefully drained, cleaned and decontaminated inside and outside prior to dispatch/
placing at your disposal.
We herewith declare that this product is free from hazardous chemicals, biological and radioactive substances.
⃞
No special safety precautions are required for further handling.
⃞
The following safety precautions are required for flushing fluids, fluid residues and disposal:
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We confirm that the above data and information are correct and complete and that dispatch is effected in accordance with the
relevant legal provisions.
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Place, date and signature
Address
Company stamp
15)
Required fields