vacuubrand DCP 3000 Instructions For Use Manual

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vacuubrand DCP 3000 Instructions For Use Manual Manual pdf 33 page image

page 33 of 36Documents are only to be used and distributed completely and unchanged. It is strictly the users´ responsibility to check carefullythe validity of this document with respect to his product. Manual-no.: 999162 // 19/01/2011Health and safety clearance formDeclaration concerning safety, potential hazards and safe disposal of waste, e. g. used oil.Safety and health of our staff, laws and regulations regarding the handling of dangerous goods, occupational health and safetyregulations, safety at work laws and regulations regarding safe disposal of waste, e. g. waste oil, require that for all pumps andother products this form must be sent to our office duly completed and signed before any equipment is dispatched to our premises.Products will not be accepted for any procedure, and handling and repair / DKD calibration will not start before we havereceived this declaration.a) Fax or post a completed copy of this form to us in advance. The declaration must arrive before the equipment. Enclose asecond, completed copy with the product. If the product is contaminated you must notify the carrier (GGVE, GGVS, RID,ADR).b) Inevitably, the repair process will be delayed considerably, if this information is missing or this procedure is not obeyed. Wehope for your understanding for these measures which are beyond our control and that you will assist us in expediting therepair procedure.c) Make sure that you know all about the substances which have been in contact with the equipment and that all ques-tions have been answered correctly and in detail.1. Product (Model): .......................................2. Serial No.: ..................................................3. List of substances in contact with theequipment or reaction products:3.1 Chemical/substance name,chemical symbol:a) ....................................................................b) ....................................................................c) ....................................................................d) ....................................................................3.2 Important information and precautions,e. g. danger classification:a) ....................................................................b) ....................................................................c) ....................................................................d) ....................................................................4. Declaration (please mark as applicable):❑ 4.1 for non dangerous goods:We assure for the returned product that- neither toxic, corrosive, biologically active, explosive, radio-active nor contamination dangerous in any way has occurred.- the product is free of dangerous substances.- the oil or residues of pumped media have been drained.❑ 4.2 for dangerous goods:We assure for the returned product that- all substances, toxic, corrosive, biologically active, explo-sive, radioactive or dangerous in any way which have beenpumped or been in contact with the product are listed in 3.1,that the information is complete and that we have not with-held any information.- the product, in accordance with regulations, has been❑ cleaned ❑ decontaminated ❑ sterilized.5. Way of transport / carrier:...........................................................................................Day of dispatch to VACUUBRAND:...........................................................................................If the paint is damaged, we wish a repaintor a replacement of parts due to optical as-pects at our expense (see ”Notes on returnto the factory”):❑ yes❑ noWe declare that the following measures -where applicable - have been taken:- The oil has been drained from the product.Important: Dispose of according to national regula-tions.- The interior of the product has been cleaned.- All inlet and outlet ports of the product have beensealed.- The product has been properly packed, if neces-sary, please order an original packaging (costs will becharged), and marked as appropriate.- The carrier has been informed about the hazardousnature of the goods (if applicable).We assure VACUUBRAND that we accept liability for anydamage caused by providing incomplete or incorrect infor-mation and that we shall indemnify VACUUBRAND fromany claims as regards damages from third parties.We are aware that as expressed in § 823 BGB (Public LawCode of Germany) we are directly liable for injuries or dam-ages suffered by third parties, particularly VACUUBRANDemployees occupied with handling/repairing the product.Signature: .........................................................................Name (print): .....................................................................Job title (print): ..................................................................Company’s seal: ...............................................................Date: .................................................................................VACUUBRAND GMBH + CO KG-Technology for Vacuum Systems-© 2008 VACUUBRAND GMBH + CO KG Printed in GermanyAlfred-Zippe-Str. 4 - 97877 WertheimTel.: +49 9342 808-0 - Fax: +49 9342 808-450E-Mail: info@vacuubrand.de - Web: www.vacuubrand.de

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