Grundfos DMX 226 Installatie- En Bedieningsinstructies pagina 536

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Please copy, fill in and sign this sheet and attach it to the pump returned for service.

Fill in this document using English or German language.

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:

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Date and signature

Safety declaration

biological and radioactive substances:

Product type: ________________________________

Model number: _____________________________

(see pump nameplate)

Fault description

Please make a circle around the damaged part.

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