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Grundfos DME AR Series - Appendix: Safety Declaration

Grundfos DME AR Series
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Appendix
326
Appendix 1
Safety declaration
Please copy, fill in and sign this sheet and attach it to the pump returned for service.
We hereby declare that this product:
Product type:____________________________
Model number:_________________________
No media or water:_________________________
A chemical solution, name:_____________________
(see pump nameplate)
is free from hazardous chemicals, biological and radioactive substances.
Fault description
Please make a circle around the damaged part.
In the case of an electrical or functional fault, please mark the cabinet.
Please give a short description of the fault:
_________________ _________________
Date and signature Company stamp
TM02 8955 1104

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