Declaration of contamination, 9 decommissioning the device – INFICON HLD6000 Refrigerant Leak Detector User Manual
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9 Decommissioning the device
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INFICON GmbH
Bonner Str. 498,50968 Cologne, Germany
Tel: +49 221 56788-112 Fax: +49 221 56788-9112
www.inficon.com [email protected]
zisa01e1-b (1106)
Declaration of Contamination
Legally binding declaration:
I/we hereby declare that the information on this form is complete and accurate and that I/we will assume any further costs that may
arise. The contaminated product will be dispatched in accordance with the applicable regulations.
Organization/company
Address
Post code, place
Phone
Fax
Name
Date and legally binding signature
Company stamp
1) or not containing any amount
of hazardous residues that
exceed
the
permissible
ex-
posure
limits
Process related contamination of product:
toxic
no
1)
yes
caustic
no
1)
yes
biological hazard
no
yes
2)
explosive
no
yes
2)
radioactive
no
yes
2)
other harmful substances no
1)
yes
The service, repair, and/or disposal of vacuum equipment and components will only be carried out if a correctly completed declaration has
been submitted. Non-completion will result in delay.
This declaration may only be completed (in block letters) and signed by authorized and qualified staff.
Copies:
Original for addressee - 1 copy for accompanying documents - 1 copy for file of sender
Harmful substances, gases and/or by-products
Please list all substances, gases, and by-products which the product may have come into contact with:
Trade/product name
Chemical name
(or symbol)
Precautions associated
with substance
Action if human contact
Description of product
Type
Article
Number
Serial
Number
Reason for return
Operating fluid(s) used (Must be drained before shipping.)
The product is free of any sub-
stances which are damaging to
health yes
This form can be downloaded
from our website.
2) Products thus contami-
nated
will
not
be
ac-
cepted
without
written
evidence
of
decontami-
nation!