Watson-Marlow 701S/R - Manual (Page 16)

Page 16
Decontamination certificate
Watson-Marlow Limited Health and Safety Declaration
1.0 This procedure is a legal requirement in the UK 3.0 Either fax this form or send by first class post
and must be used when returning pumps and to Watson-Marlow (or its distributor) to ensure
equipment for service at Watson-Marlow (or its that we have the information before receipt of the
distributor). equipment.
2.0 Pumps returned for service must be cleaned. A further copy must be attached to the
You are responsible for their decontamination. outside of the shipping case.
Failure to complete the form or comply with the procedure will cause delays in servicing the equipment.
4.0 Company .......................................................................................................................................................
Address
.......................................................................................................................................................
.........................................................
Post Code........................................................
Telephone ......................................................... Fax number......................................................
5.0 Please complete all the following sections 5.4 If substances are not hazardous nor toxic,
please complete section 5.4.1.
If substances are hazardous or toxic,
5.1 Pump Type....................................................... please complete section 5.4.2.
5.2 Serial number................................................... 5.4.1 I hereby confirm that the equipment specified
has not pumped nor come into contact with
any toxic or hazardous substances.
5.3 Details of substances pumped
Signed.............................................................
5.3.1 Chemical names: Name...............................................................
(a) ................................................................... Position...........................................................
(b) ................................................................... Date.................................................................
(c) ...................................................................
(d) ...................................................................
5.4.2 I hereby confirm that the only toxic or
hazardous substance(s) that the equipment
5.3.2 Precautions to be taken in handling these specified has pumped or come into contact
substances: with are those named, and that the
(a) ................................................................... information given is correct and the carrier
(b) ................................................................... has been informed if the consignment is of
(c) ................................................................... a hazardous nature.
(d) ...................................................................
Signed.............................................................
5.3.3 Action to be taken in the event of human Name..............................................................
contact: Position...........................................................
(a) ................................................................... Date................................................................
(b) ...................................................................
(c) ...................................................................
5.5 Carrier to be used
(d) ................................................................... ........................................................................
Delivery date
5.3.4 Cleaning fluid to be used if residue of ........................................................................
chemicals is found during servicing:
(a) ...................................................................
5.6 Fault description or any other information
(b) ................................................................... ........................................................................
(c) ................................................................... ........................................................................
(d) ................................................................... ........................................................................
........................................................................
........................................................................
IMPORTANT Before returning any product for service, this form must be completed and sent to
Watson-Marlow, or its subsidiary, or its official distributor undertaking the service
Watson-Marlow Limited, Falmouth, Cornwall TR11 4RU, England. Tel 01326 370370, Fax 01326 376009