BUCHI Rotavapo R-100 - Manual (Page 58)

10 | Appendix BÜCHI Labortechnik AG
58/60 Operation Manual Rotavapor® R­100
10.5 Health and safety
Declaration regarding the safety, hazards and safe disposal of waste
To guarantee the health and safety of our staff and to comply with the law and the reg­
ulations for handling hazardous materials, regarding health and safety at work, and to
comply with safety regulations, health and safety requirements and requirements for
safe disposal of waste such as chemical waste, chemical residues or solvents, the
form below must be fully completed and signed whenever devices or faulty compo­
nents are to be sent back to our factory.
Products or components will not be accepted if this declaration has not been
provided.
Device
Model: Part/Device no.:
Declaration for
non­hazardous
materials
We hereby assure that the products returned
have not been used in the laboratory and are new.
have not been in contact with toxic, corrosive, biologically active, explosive, ra­
dioactive or other hazardous materials.
are not contaminated. The solvents or residues of the substances pumped have
been removed.
Declaration for
hazardous materi­
als
In respect of the products returned, we hereby assure that
all substances (toxic, corrosive, biologically active, explosive, radioactive or other­
wise hazardous) that have been pumped by the products or have otherwise been
in contact with the products are listed below.
the products have been cleaned, decontaminated, sterilised inside and outside
and all inlets and outlets are sealed.
List of hazardous materials that have been in contact with the products:
Chemical, material Hazard category
Final declaration We hereby declare that
— we are fully conversant with the substances that have been in contact with the prod­
ucts and have answered all questions correctly.
— we have taken all measures necessary to prevent potential hazards in respect of
the products returned.
Company name or stamp:
Place, date:
Name (block letters), position
(block letters):
Signature: