WOERNER PMF - Page 35

Operating manual PMF/GMF Page 35 of 37 B0343
Declaration of Harmlessness
Firm:
Address:
We herewith confirm for the product(s) returned from us that
Product
designation:
Woerner
order number:
1. All the components have been completely drained and cleaned,
2. the remaining residual contaminations are free of health and environment hazardous
substances, and
3. the substances used in the product(s) correspond to the instructions in the product
documentations regarding intended purpose of application and use according to
design. The respective safety sheets have been attached.
Date of return:
Name, position:
Phone number:
Date,
signature:
Firm stamp:
Appendices:
Safety data sheet