Contamination declaration
With return of devices, please fill out the following statement completely, especially the reason for
the return, the type of residue and cleaning in the case of soiling, as well as indication of hazards.
Device came in contact with:
Can you provide further
information on the
contamination?
inert (no danger)
corrosive
caustic
must not come in contact with moisture
oxidizing
other hazards:
For the protection of our employees and for general safety during transport, proper cleaning and
the use of appropriate packaging are mandatory.
We hereby confirm the correctness and completeness of the above information: