Bijlage
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 langu-
N.B.
age.
We hereby declare that this product is free from hazardous chemicals, biological and radioactive
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
50
Safety declaration
substances:
Product type: ________________________________
Model number: _____________________________
(see pump nameplate)
Fault description
Please make a circle around the damaged part.
_____________________
Company stamp
1