Binder KBWF 240 Bedienungsanleitung PDF herunterladen (Seite 103)

KBWF (E5.2) 07/2013 page 103/104

Customer (End User) Decontamination Declaration

Health and Hazard Safety declaration

To protect the health of our employees and the safety at the workplace, we require that this form is com-

pleted by the user for all products and parts that are returned to us. (Distributors or Service Organizations

cannot sign this form)

NO RMA number will be issued without a completed form. Products or parts returned to our

NY warehouse without a RMA number will be refused at the dock.

A second copy of the completed form must be attached to the outside of the shipping box.

1. Unit/ component part / type

2. Serial No.

3. List any exposure to hazardous liquids, gasses or substances and radioactive material

3.1 List with MSDS sheets attached where available or needed

(if there is not enough space available below, please attach a page):

a) ____________________________________________________________________________

b) ____________________________________________________________________________

c) ____________________________________________________________________________

3.2 Safety measures required for handling the list under 3.1

a) ____________________________________________________________________________

b) ____________________________________________________________________________

c) ____________________________________________________________________________

3.3 Measures to be taken in case of skin contact or release into the atmosphere:

a) ____________________________________________________________________________

b) ____________________________________________________________________________

c) ____________________________________________________________________________

d) ____________________________________________________________________________

3.4 Other important information that must be considered

a) ____________________________________________________________________________

b) ____________________________________________________________________________

c) ____________________________________________________________________________

1 2 ... 98 99 100 101 102 103 104 105

Keine Kommentare

Binder KBWF 240 Bedienungsanleitung Seite 103