Appendix
9.3 Safety certificate
Please copy this document and send it together with the
pump.
The pump and accessories submitted for in spection / repairs toge ther with the safety certificate by us, t he si gnatory:
Type: Delivery date:
Part no.:
Order no.:
Reason for inspection / repair:
Was not used with liq uids that are hazardo us to health or the environment.
Was used f or the following application:
Came into contact with liquids that mu st be l abeled for safety or are considered to be polluting.
Last pumped liquid:
The pump has been carefully emptied a nd cleaned on the outside a nd inside prior to deliver y or provision.
Special safety precautions are n ot necessary for subse quent han dling.
The following safety precautions regarding rinsing liquids , liquid residue and disposal are necessary:
If the pump was used with critical liquids, please make sure you enclose a safety data sheet in the
package.
We here by declare that the information given is correct and complete , and that the pump is being shipped in accordan ce with
legal require ments.
Company /
address:
Phone:
Fax:
Customer no.: ____ ____ ____ ____ ____ ____ ____
Issuer name:
(capital letters)
Position:
Date: Company stamp / signature:
Tab. 18 Safety certificate
626.0005 GB – 550 041 BA-2014.01 SPF s eries 33
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