Page33
Annex
Certificate of No Objection
We, the undersigned, submit the following pump and pump accessories for repair I inspection:
Type:
................................. Please note:
Specification: ......... ...... ...,. ........ This certificate must be filled out
and enclosed with any shipment
for repair purposes to ensure
proper handling of the pump.
Series no..:.. ... ......
Cause of inspection/repair order:
The pump and/or pump accessories:
has/have not been used to pump any liquids that are harmful to health;
was/were used for
(type of use)..............
was/were in contact with liquids subject to labelling requirements under the law on
hazardous substances and/or dangerous goods. If known, please state the last medium
pumped: ....................................................................
Prior to shipment / provision the pump has been carefully drained and cleaned both inside and outside with a
suitable cleaning agent.
No special safety precautions are required for further handling.
The following safety precautions are required in relation to flushing fluids, residual fluids and
disposal:
We, the undersigned, confirm that the information provided above is correct and complete and
shipment is in compliance with legal regulations.
Company:
Department:
Contact:
Phone:
Fax:
Address:
Street:
Postal code / town
………………………………………………
Place I date / company stamp / signature
To Next Page
Loading...
