Declaration of contamination, 9 wyłączanie z eksploatacji – INFICON Ecotec E3000 Multigas-Sniffer-Leak Detector Instrukcja Obsługi

Strona 82

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9 Wyłączanie z eksploatacji

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1407

INFICON GmbH

Bonner Str. 498,50968 Cologne, Germany
Tel: +49 221 56788-112 Fax: +49 221 56788-9112
www.inficon.com [email protected]

zisa01e1-b (1106)

Declaration of Contamination

Legally binding declaration:

I/we hereby declare that the information on this form is complete and accurate and that I/we will assume any further costs that may

arise. The contaminated product will be dispatched in accordance with the applicable regulations.

Organization/company

Address

Post code, place

Phone

Fax

Email

Name

Date and legally binding signature

Company stamp

1) or not containing any amount

of hazardous residues that

exceed

the

permissible

ex-

posure

limits

Process related contamination of product:

toxic

no

‰ 1)

yes

‰

caustic

no

‰ 1)

yes

‰

biological hazard

no

‰

yes

‰ 2)

explosive

no

‰

yes

‰ 2)

radioactive

no

‰

yes

‰ 2)

other harmful substances no

‰ 1)

yes

‰

The service, repair, and/or disposal of vacuum equipment and components will only be carried out if a correctly completed declaration has
been submitted. Non-completion will result in delay.
This declaration may only be completed (in block letters) and signed by authorized and qualified staff.

Copies:
Original for addressee - 1 copy for accompanying documents - 1 copy for file of sender

Harmful substances, gases and/or by-products

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

Trade/product name

Chemical name
(or symbol)

Precautions associated
with substance

Action if human contact

Description of product

Type

Article

Number

Serial

Number

Reason for return

Operating fluid(s) used (Must be drained before shipping.)

The product is free of any sub-
stances which are damaging to
health yes

‰

This form can be downloaded
from our website.

2) Products thus contami-
nated

will

not

be

ac-

cepted

without

written

evidence

of

decontami-

nation!

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