KROHNE H54 M4 EN - Manual (Page 16)

H54 Installation and Operating Instructions 16
Form for returning the instrument
Company: ......................................................
Address: .......................................................................
Department: ..................................................
Name: ..........................................................................
Tel. No.: ........................................................
Fax. No.: ......................................................................
The enclosed instrument
Type: ...............................................................................................................................................................
KROHNE Order No. or Series No.:.................................................................................................................
has been operated with the following process liquid: .....................................................................................
Because this process liquid is water-endangering * / toxic * / caustic * / flammable *
we have
- Checked that all cavities in the instrument are free from such substances *
- Flushed out and neutralized all cavities in the instrument *
(* delete where not applicable)
We confirm that there is no risk to man or environment through any residual liquid contained in the instrument.
Date: .............................................................
Signature.......................................................................
Company stamp: