Declaration Of No Objection - Heidolph Hei-TORQUE Core Betriebsanleitung

Appendix

Declaration of no objection

Enclose the declaration of no objection, duly completed, with your device return.
Submissions without a declaration of no objection cannot be processed!
1. Information on the device
Item number:
Serial number:
Reason for submission:
Does this product pose a risk to people and/or the environment due to
2. its use for processing substances that are hazardous to health, the envi-
ronment and/or are biohazardous? Please add details!
If YES, with which
substances did the
device come into
contact?
If NO, what cleaning
and/or decontamination
measures were carried
out?
3. Information on the client/sender:
Full name:
Company/institution:
Department/working
group:
Address:
Zip code, city:
Country:
Phone:
Email:
4. Legally binding declaration
With his signature, the client/submitter declares the completeness and correct-
ness of this details. Missing or incorrect information obligates to compensation
for damages.
Date Signature, company stamp
55