
IM-P309-02
MI Issue 2
77
19. Decontamination certificate for
device cleaning
Company name: ...............................
Address: ...............................................
Department: ....................................
Name of contact person: ....................
Phone: .................................
Information pertaining to the enclosed flowmeter
Model ELM- ................
was operated using the following fluid: ........................................
In as much as this fluid is water-hazardous / toxic / corrosive / combustible
we have done the following:
Checked all cavities in the device to ensure that they are free of fluid residues*
Washed and neutralized all cavities in the device*
*cross out all non-applicable items
We hereby warrant that no health or environmental hazard will arise from any fluid
residues on or in the enclosed device.
Date: .............................
Signature: ...........................
Stamp
Содержание ELM
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