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11 Certificate of Decontamination

Type ................................................................................................................................

Order number/

Order item number

31)

................................................................................................................................

Delivery date ................................................................................................................................

Field of application: ................................................................................................................................

Fluid handled

31)

................................................................................................................................

Please tick where applicable

31)

   

radioactive explosive corrosive toxic

   

harmful bio-hazardous highly flammable safe

Reason for return

31)

................................................................................................................................

Comments: ................................................................................................................................

................................................................................................................................

The pump/accessories have been carefully drained, cleaned and decontaminated inside and outside prior to dispatch/placing

at your disposal.

On sealless pumps, the rotor has been removed from the pump for cleaning.

 No special safety precautions are required for further handling.

 The following safety precautions are required for flushing fluids, fluid residues and disposal:

...............................................................................................................................................................

We confirm that the above data and information are correct and complete and that dispatch is effected in accordance with

the relevant legal provisions.

.................................................................... ....................................................... .......................................................

Place, date and signature Address Company stamp

31)

Required fields

11 Certificate of Decontamination

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KWP