airPUMP
AP025
(plastic)
26
www.sera-web.com
CLEARENCE CERTIFICATE
NOTE
Inspection / repair of machines and machine parts is only carried out after the clearance certificate was filled in correctly
and completely by authorized and qualified personnel.
NOTE
Acceptance will be refused if parts are returned to the manufacturer without a proper clearance certificate.
All industrial companies are obligated by the legal provisions for occupational health, e.g. the workplaces ordinances, the Ordi-
nance on Hazardous Substances, the regulations for prevention of accidents and the environmental protection regulations such
as the Waste Management Act and the German Household Water Act to protect their employees or man and the environment
from detrimental effects when handling hazardous substances.
Should special safety precautions be necessary despite careful draining and cleaning of the product the necessary information
are to be provided.
Machines which are operated with radioactive media shall only be inspected and/or repaired in the safety area of the owner
by a
sera
specialized fitter.
The clearance certificate is part of the inspection-/repair order.
sera
reserves the right to refuse acceptance of the order for other reasons.
www.sera-web.com
Clearance Certificate
QSF469-02 Clearance Cer
tificate EN 09/2021.
sera
is a registered trademark of sera GmbH
Company:
Contact partner:
Street address:
Postcode, City:
SENDER
Phone:
Fax:
E-Mail:
Your order number:
We confirm that we have entered the information in this clearance certificate (decontaminati-
on certificate) correctly and completely and that the returned parts have been carefully cleaned.
The parts sent in are therefore free of residues in dangerous quantities.
Place, Date
Department
Signature (and company stamp)
sera ProDos GmbH
Wareneingang z. Hd. Abt. Service
sera
Straße 1
D-34376 Immenhausen/Hessen
RECIPIENT
DOWNLOAD
Clearance certificate
Or directly scan
the QR code opposite:
