Safety Declaration - Grundfos CM Installation And Operating Instructions Manual

18. Safety declaration

Please copy, fill in and sign this sheet and attach it to the pump returned for service.
Liquid and application
Which liquid has the pump been used for: ______________________
In which application has the pump been used: ____________________
Fault description
If possible, please make a circle around the faulty part.
(In case of an electrical fault, please mark the terminal box.)
Please give a short description of the fault:
We hereby declare that this product is free from hazardous chemicals, biological
and radioactive substances.
__________________________________________________
Date and signature/Company stamp
15