Heidolph MR Hei-Mix D - Manual (Page 23)

15
Confirmation of condition of unit
 In the case of repair, copy and complete the Conformation of condition of unit and send it to Heidolph
Instruments (see chapter "Technical Service"
).
1. Details about the unit
Product number
Serial number
Reason for repair
2. Has the device been cleaned, decontaminated/sterilized?
yes no
3. Is the unit in a condition which does not represent any health threats for the staff of our
service department?
yes no
if not, which substances has the
unit come into contact with?
4. Legally binding declaration
The customer is aware of being legally liable to Heidolph Instruments
for any damages arising from incomplete and incorrect information.
Date Signature
Company stamp
Please note
The shipper is responsible for the return of the goods in wellpacked
condition, suitable for the mode of transport.
Sender information
Name, first name
Company
Department, research group
Street
Zip code, city
Country
Phone
E-mail