** Si dichiara che la pompa in oggetto è stata accuratamente pulita e lavata da ogni traccia dei
Le date di consegna verranno concordate e comunicate di volta in volta con il nostro personale.
I tempi necessari per le riparazioni saranno concordati con il nostro personale
Problematica riscontrata
4: 8:
Temperatura di esercizio : °C =
Pressione di azionamento : min./max.
ATTENZIONE
campi obbligatori (
*) (**)
1: 5:
2: 6:
3: 7:
Codice
N° Matricola/seriale
Interventi precedenti effettuati da: in data:
Telef.
Dati Pompa
Modello
D.D.T. di riferimento
Email.
Documento accompagnatorio a DDT in c.to riparazione
( Obbligatorio* )
Azienda
Persona di riferimento
M-QUA03-02 Rev. 00 del 05/01/18 Pag. 1 di 1
Company
Reference person
Tel.
Email.
Reference Delivery Note
Pump data
Model
Code
Serial no.
Previous intervenons carried out by in date:
Encountered problem
Types of uid transferred by the pump (specify % if acid)
compulsory elds (*) (**)
1: 5:
2: 6:
3: 7:
4: 8:
Operang temperatures : °C =
Acvaon pressure : min./max.
CAUTION
** We declare that the pump in queson was thoroughly cleaned and washed from all traces of products for which
it was used and is therefore free form pollutants and/or products damaging for the environment, their features
are described above in detail.
* Not lling this format will make it impossible to perform a repair quote with the consequent return of the goods
to the sender.
DEBEM reserves the right to not perform repair on pumps dedicated to the transfer of substances which are
potenally dangerous to the health of the operator and the environment.
DEBEM scrupulously follows current regulaons regarding waste disposal and is not allowed to dispose of any
kind and/or type of liquids.
The delivery dates will be decided and agreed on a case to case basis with our personnel.
The me required for repairs will be decided with our personnel
Date __/__/____
Stamp and signature____________________________
Document aached to Delivery Note in repair cost
( Compulsory*)
Rev. 00 of 05/01/18 Page 1 of 1