Teikoku USA | Chempump
Instruction Manual G-Series
46
Appx. R. Decontamination Certification and Flushing Procedure
DECONTAMINATION CERTIFICATION
AND FLUSHING PROCEDURE
CUSTOMER
ADDRESS:
CONTACT:
EMAIL:
DATE:
PHONE:
FAX:
RMA #:
Please complete the items below. Providing this information will allow us to work as quickly and safely as possible.
PUMP MODEL:
PART NUMBER:
DATE PURCHASED:
SERIAL NUMBER:
DATE INSTALLED:
INDOOR / OUTDOOR:_
REASON FOR RETURN:
WARRANTY REQUEST
FACTORY SERVICE
FAILURE INFORMATION:
Failure To Deliver Required Capacity
Vibration
Motor Burnout
Loses Prime After Starting
Bearing Failure
Bearing Monitor reading:
Axial Wear Due To Thrust
Insufficient Pressure
Other:
BRIEF DESCRIPTION OF PUMP FAILURE:
DECONTAMINATION INFORMATION
All pumps/parts must be completely decontaminated and all information in this section must be completed prior to
shipment to our factory or service center. Shipments received without this documentation will not be accepted and
will be returned to the point of shipment.
CHECK ONE OF THE FOLLOWING:
The pump has been flushed by following steps A through
Both the complete pump and the stator assembly have
A3 of the Teikoku USA Flushing Procedure on page 2 of
been flushed by following steps A through B3 of the
this form. No liner rupture is suspected.
Teikoku USA Flushing Procedure on page 2 of this
form. The motor must be rewound.
FLUID PUMPED:
WHAT FLUID DID YOU FLUSH WITH:
Attach completed material safety data sheets (MSDS) for these fluids. If either fluid is proprietary, please attach a
description of any characteristics that will assist
Teikoku USA
in safe handling. Without detailed and complete information
on the pumped fluid, we will not be able to process your order.
PROTECTION EQUIPMENT RECOMMENDED FOR SAFE HANDLING OF THE PROCESS FLUID:
DECONTAMINATION CERTIFIED BY:
DATE:
TITLE:
PHONE:
RETURN COMPLETED FORM AND PUMP/PART TO:
TEIKOKU USA
FACTORY SERVICE CENTER
959 MEARNS ROAD
WARMINSTER, PA 18974
PHONE: (215) 343-6000
FAX: (267) 486-1037
TEIKOKU USA
MIDWEST SERVICE CENTER
27881
STATE ROUTE
7
MARIETTA, OH 45750
PHONE: (740) 538-5332
FAX (740) 538-5015
TEIKOKU USA
SALES AND SERVICE CENTER
5880 BINGLE ROAD
HOUSTON, TX 77092
PHONE: (713) 983-9901
FAX: (713) 983-9919
