Oxford Instruments OpAL - Goods Return Form QCF

QCF 60 Issue 5 15/06/07
Environmental Agency Producer
Regist
ration Number for WEEE:
WEE/AE0116XU
Returns No :
GOODS RETURN FORM
• This form must be completed and a copy sent to Oxford Plasma Technology Service Department by fax or
mail before return of any goods to the factory. (Fax No : + 44 (0) 1934 837071)
• If return to the factory is approved a Returns Authorisation Number will be issued. This should be written in the box
provided on this form and the completed form returned with the goods as part of the shipping documentation. It
must be possible to read this form without opening the packaging containing the goods, therefore the
form should not be enclosed within the packaging but affixed to the container.
• Once the Returns Authorisation Number is issued goods should be returned within one month.
OIPT reserve the right to invoice the full value of parts if not returned.
• All sections below must be completed. If any section does not apply, mark that section "not
applicable". If the information requested is not known, mark that section "not known".
• Any goods returned to the factory without a copy of this form carrying a Returns Authorisation Number
will be considered hazardous and may be disposed of at the sender's expense. Mark the returns number
on all packages and supporting shipping documentation.
Equipment description. Serial number or identifying marking
Original OIPT order No : Date of order :
Reason for return of part/s.
Description of fault/s.
Chemical names of all materials which have come into
contact with the goods.
Precautions which must be taken when handling these
materials.
Nature of hazard(s) presented by contact with these
materials.
Action to be taken in the event of human contact or
spillage of these materials.
Details of any decontamination carried out prior to
shipping
.
Levels of residual substances left in or on the returned
goods.
Name and address of person to be contacted in case of
query.
Tel No : Ext :
Fax No :
Declaration
Please strike through the section a) or b) which does not apply and sign the declaration.
a) I hereby confirm that the equipment detailed above has not come into contact with any hazardous substance
and has been drained of any lubricant.
b) I hereby confirm that the only hazardous materials to which the equipment detailed above has been exposed
are listed above and that the following precautions have been taken.
1. The equipment has been drained of any lubricant
2. All ports have been sealed and the equipment has been securely packed and labelled in accordance with
Oxford Instruments Plasma Technology recommendations (available on request)
3. The carrier has been informed of the nature of the consignment.
Signed. . . . . . . . . . . . . . . . . . . . . . . . . . . . Date. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . Position. . . . . . . . . . . . . . . . . . . . . . . . . .