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Tradename

Chemical name

Danger class

Precautions associated  Action if spillage or human 

Product name

(or Symbol)

with substance

contact

Manufacturer

1.

2.

3.

4.

5.

5.

Legally Binding Declaration

I hereby declare that the information supplied on this form is complete and accurate. The despatch of equipment will be in
accordance with the appropriate regulations covering Packaging, Transportation and Labelling of Dangerous Substances.

Name of Organisation: _______________________________________________________________________________

Address:

_____________________________________

Post code: _____________________________________

Tel.: ______________________________________________________________________________________

Fax:

_____________________________________

Telex: ________________________________________

Name:  

______________________________________________________________________________________

Job title:

______________________________________________________________________________________

Date:

_____________________________________

Company stamp: ________________________________

Legally binding signature: _____________________________________________________________________________

Declaration of Contamination of Vacuum Equipment and Components

The repair and/or service of vacuum components will only be
carried out if a correctly completed declaration has been
submitted. Non-completion will result in delay. 

The manufacturer could refuse to accept any equipment
without a declaration.

This declaration can only be completed and signed by authorised and qualified staff:

1. Description of component:

- Equipment type/model: _________________________

- Code No.:

__________________________

- Serial No.:

__________________________

- Invoice No.:

__________________________

- Delivery Date:

__________________________

3. Equipment condition

- Has the equipment been used?

yes  

no 

- What type of pump oil was used?

___________________________________________

- Is the equipment free from potentially harmful

substances?

yes 

(go to section 5)

no 

(go to section 4)

4. Process related contamination

of equipment

- toxic

yes 

no 

- corrosive

yes 

no 

- microbiological hazard*)

yes 

no 

- explosive*)

yes 

no 

- radioactive*)

yes 

❐ 

no 

- other harmful substances yes 

no 

*) We will not accept delivery of any equipment that has been radioactively or microbiologically contaminated without written

evidence of decontamination!

2. Reason for return:

_____________________________________________

_____________________________________________

_____________________________________________

_____________________________________________

_____________________________________________

Please list all substances, gases and by-products which may have come into contact with the equipment:

Содержание DUO 004 B

Страница 1: ...Betriebsanleitung Service Instructions Instructions de service Drehschiebervakuumpumpen Rotary Vane Pumps Pompes Rotatives Palettes UNO DUO 004 B UNO DUO 008 B UNO DUO 016 B PK 800 115 BN H_part3 0010...

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Страница 27: ...this work to you if you have not attached this note This also applies where the operator does not have the facilities to carry out the decontamination work Units which are contaminated microbiological...

Страница 28: ...ccording to our general conditions of sale and supply If repairs are necessary please send the unit to your nearest PFEIFFER Service Center Contact Addresses And Service Hotline Contact addresses and...

Страница 29: ...t das nicht der Fall kommt es zu Verz gerungen der Arbeiten Wenn die Reparatur Wartung im Herstellerwerk und nicht am Ort ihres Einsatzes erfolgen soll wird die Sendung gegebenenfalls zur ckgewiesen D...

Страница 30: ...repair and or service of vacuum components will only be carried out if a correctly completed declaration has been submitted Non completion will result in delay The manufacturer could refuse to accept...

Страница 31: ...amination de mat riel de technique du vide Notre service peut intervenir et s occuper du mat riel seule ment si vous l avez envoy avec certificat pr cisement rem pli Selon l etat du mat riel nous nous...

Страница 32: ...tate in basso le direttive aplicate le norme standardizzate non ch le norme e le specifiche nazionali utilizatte E E E ES S S S Declaraci n de conformidad al tenor de las siguientes Directivas de la U...

Страница 33: ...G G GR R R R Produkt Product Produit Prodotto Producto Produkt Produkt Produto UNO 004 B UNO 008 B UNO 016 B DUO 004 B DUO 008 B DUO 016 B Angewendete Richtlinien harmonisierte Normen und angewendete...

Страница 34: ...662 259 4623 telefax 662 259 6243 U S A Pfeiffer Vacuum Inc 24 Trafalgar Square Nashua NH 03063 1988 USA telephone 1 603 578 6500 telefax 1 603 578 6550 Venezuela Secotec S A Apartado 3452 Caracas 10...

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