Grundfos DMS Serie Montage- Und Betriebsanleitung Seite 251

Please copy, fill in and sign this sheet and attach it to the pump returned for service.
is free from hazardous chemicals, biological and radioactive substances.
In the case of an electrical or functional fault, please mark the cabinet.
100%
Please give a short description of the fault:
_________________
Date and signature
Safety declaration
We hereby declare that this product:
Product type:____________________________
Model number:_________________________
No liquid or water:____________________________
Chemical, name:_________________________
(see pump nameplate)
Fault description
Please make a circle around the damaged part.
ml/h
_________________
Company stamp
251