AGT PSG BCR01 Installation Manual, Operating Manual, Maintenance Manual, Spare Part List page 26

Installation-, Operating-, Maintenance-Manual, Spare Part List
Return / Maintenance and Repair
Declaration of Contamination Status
Legal regulations prescribe to fill in and sign the declaration of contamination status and send it back.
This information is used to protect our employees. Please attach the declaration to the packing.
Otherwise your repair cannot be processed.
Gevice / Articlenumber / Serialnumber:
Reason for return:

I herewith declare that the device specified above has been properly cleaned and decontaminated and
that there are no risks present when dealing with the device.
In other cases, please describe the hazards in detail:

Explosives

Environmental hazard

Liquid
Please include the current material safety data sheet of the hazardous material!
Company, Contact
AGT-PSG GmbH & Co.KG
Errors and printing mistakes excepted

Acute toxicity

Corrosive

Solid

Flammable

Irritant toxicity

Powdery
Location, Date, Stamp, Signature
Translation - Manual BCR01 Rev. 6/2017
BCR01

Oxidizing

Health hazard

Gaseous
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