Appendix
Please copy, fill in and sign this sheet and attach it to the pump returned for service.
We hereby declare that this product is free from hazardous chemicals,
No media or water: _____________________________
A chemical solution, name: _________________________
In the case of an electrical or functional fault, please mark the cabinet.
Please give a short description of the fault:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_____________________
Date and signature
258
Safety declaration
Note
Fill in this document using English or German language.
biological and radioactive substances:
Product type: ________________________________
Model number: _____________________________
(see pump nameplate)
Fault description
Please make a circle around the damaged part.
_____________________
Company stamp
1