VACUUBRAND VHC Pro - Manual (Page 26)

page 26 of 27
Documents are only to be used and distributed completely and unchanged. It is strictly the users´ responsibility to check carefully
the validity of this document with respect to his product. 25/11/2013 // 999281
Description of the decontamination method:
Outside: ...............................................................................................................................................
Inside (e. g. bottle, screw cap, coupling, filter, hoses, handle): ............................................................
.............................................................................................................................................................
.............................................................................................................................................................
Interior (vacuum pump, vacuum sensor): ............................................................................................
.............................................................................................................................................................
.............................................................................................................................................................
10. Risk level 2 and higher: The device may only send for repair if it is ensured that also the
vacuum pump is not contaminated.
The vacuum pump has been checked for internal contamination and is not contaminated:
☐
yes
☐
no
11. All parts of the device are free of hazardous, harmful substances :
☐
yes
☐
no
12. Protective measures required for VACUUBRAND employees:
..............................................................................................................................................................
13. If the paint is damaged, we wish a repaint or a replacement of parts for reason of appearance
(repaint and replacement at customer’s expense).
☐
yes
☐
no
14. Legally binding declaration
We assure for the returned device that all substances, which have been in contact with the device are
listed in section 5 and that the information is complete and that we have not withheld any information. We
declare that all measures - where applicable - have been taken listed in section “Return to the factory”.
By our signature below, we acknowledge that we accept liability for any damage caused by providing
incomplete or incorrect information and that we shall indemnify VACUUBRAND from any claims as
regards damages from third parties. We are aware that as expressed in § 823 BGB (Public Law Code
of Germany) we are directly liable for injuries or damages suffered by third parties, particularly
VACUUBRAND employees occupied with handling/repairing the product.
Shipping of the device must take place according to regulations.
Name: .................................................................. Signature: ............................................................
Job title: ................................................................... Company’s seal:
Date: ........................................................................
Release for repair grant by VACUUBRAND (date / signature) : ...................................................................................................................
Protective measures: ☐ Protective gloves, -glasses ☐ Hood ☐ External cleaning
VACUUBRAND GMBH + CO KG
Alfred-Zippe-Straße 4
97877 Wertheim
Germany
Tel.: +49 9342 808-5660
Fax: +49 9342 808-5666
E-Mail: [email protected]
www.vacuubrand.com
Health and safety clearance form BVC page 2 of 2