Certificate of non-objection
This section contains a certificate of non-objection. In the event of
inspection or repair send the pump including this certificate to
HILGE.
Certificate of non-objection
The following pump and its accessories, together with this
certificate of non-objection, are herewith contracted out by the
undersigned for inspection/repair:
Pump data
• Model:
• No.:
• Delivery date:
Reason for inspection / repair contract
The pump (please mark with a cross)
___ was not used in liquids hazardous to health
___ was used for the following:
Please state the last liquid pumped, if known:
The pump was carefully drained an
d also cleaned inside and out
before it was shipped/made available. (please mark with a cross).
___ No special safety measures are required in the course of
further handling.
___ The following safety measures pertaining to flushing liquids,
residual liquids, and disposal are required:
We confirm that the information given above is correct and
complete and that shipment is in compliance with legal
regulations.
Company (address):
Telephone:
Fax:
Email:
Name (incl. title)
(please print):
Date:
Company stamp /
signature:
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