Endress+Hauser prosonic flow 92 - Page 97

More information about services and repairs:
www.services.endress.com
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Dear customer,
Because of legal determinations and for the safety of our employees and operating equipment we need this
“Declaration of contamination” with your signature before your order can be handled. Please put the completely
filled in declaration to the instrument and to the shipping documents in any case. Add also safety sheets and/or
specific handling instructions if necessary.
type of instrument / sensor: __________________________________ serial number: _______________________
medium / concentration: __________________________________ temperature: ______ pressure: _______
cleaned with: __________________________________ conductivity: ______ viscosity: _______
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o
radioactive
o
explosive
o
caustic
o
poisonous
o
harmful to
health
o
biologically
hazardous
o
inflammable
o
safe
Please mark the appropriate warning hints.
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company: ______________________________ contact person: _________________________
______________________________ _________________________
______________________________ department: _________________________
address: ______________________________ phone number: _________________________
______________________________ fax / e-mail: _________________________
______________________________ your order no.: _________________________
I hereby certify that the returned equipment has been cleaned and decontaminated acc. to good industrial prac-
tices and is in compliance with all regulations. This equipment poses no health or safety risks due to contamination.
_______________________________ ___________________________________
(Date) (company stamp and legally binding signature)
SAFE