Setra Systems 206, Руководство по эксплуатации

Страница: 8 / 8

7.0 Return of Setra Systems Product - Declaration
(Form 206ERN)
EXPECTED RETURN NUMBER ______________________________________________________________
You must:
• Know about all of the substances which have been used and produced in the product
before you complete this Declaration.
• Contact your supplier if you have any questions and for an ERN Number.
• Send this form to your supplier with the return of the product.
SECTION 1: Product
A. Model Number ____________________________
B. Serial Number ____________________________
C. Has the product been used, tested or operated?
Yes - Go to Section 2 No - Go to Section 4
SECTION 2: Substances in Contact with the Product
A. Radioactive*
Yes No
B. Biologically Active Yes No
C. Dangerous to Human Health and Safety? Yes No
*Note: Your supplier will not accept delivery of any products that are contaminated with radio-
active substances, unless you:
• Decontaminate the products
• Provide proof of decontamination
YOU MUST CONTACT YOUR SUPPLIER FOR ADVICE BEFORE YOU RETURN SUCH PRODUCTS
If you have answered “no” to all of these questions, go to Section 4.
SECTION 3: List of Substances in Contact with the Product
SECTION 4: Return Information
Reason for return and symptoms of malfunction: ___________________________________________
_____________________________________________________________________________________________
If you have a warranty claim:
• Who did you buy the product from?: _______________________________________________________
• Give the supplier’s invoice number or your purchase order number: ________________________
SECTION 5: Declaration
Print your Name:_______________________________ Print Your Job Title: ______________________
Print Your Company Name: _________________________________________________________________
Print Your Address: _________________________________________________________________________
Telephone Number: ____________________________ Date of Product Return: ___________________
I have made reasonable inquiry and I have supplied accurate information in this Declaration.
I have not withheld any information. I have followed the Return of Setra Systems Product
Procedure.
Signed: ________________________________________ Date: ___________________
Substance
Name
Chemical
Symbol
Precautions Required (eg:
use protective gloves, etc.)
Actions Required After
Spillage or Human Contact
1.
2.
3.
4.
5.
6.
SS0478 Re
v. H 07/2017