RETURN REPORT – No.: _ _ _ _ _ _ _ _
*) Please always fill in. Otherwise the case will not be handled as return
ABB
CONTROL OF SUBSTANCES HAZARDOUS TO HEALTH (C.O.S.H.H.)
Decontamination declaration - EQUIPMENT RETURNED FOR REPAIR, CALIBRATION OR CREDIT
From
Description
Return authorization no.
Model number
Serial number
A)
The above equipment has not been in contact with any material which is hazardous to health.
B)
The above equipment has been in contact with the material(s) noted below but that it has now been
completely de-contaminated and is now safe to handle and dismantle without any special precautions.
Material(s) which have been in contact with this equipment:
C)
If A) or B) are not applicable full instructions for the safe handling of this equipment for disposal
must be
supplied.
Please delete A), B) or C) above as applicable, complete the signature section below, then send the completed
declaration either with the returned items, or by fax for the attention of the Calibration & Repair Centre..
Note – no action to examine or repair equipment will be undertaken until a valid COSHH declaration has been
received, completed by an authorized officer of the end user company.
Signed
Name
Position
Date
ABB S.p.A
Process Automation Division
Uffici Commerciali / Sales Office:
Via Statale, 113 - 22016 Lenno (CO) Italy
Tel. +39 0344 58 111
Fax +39 0344 56 278
e-mail: abb.instrumentation@it.abb.com
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