BÜCHILabortechnikAG Appendix|10
OperationManualInterfaceI100 39/42
10.5 Healthandsafety
Declarationregardingthesafety,hazardsandsafedisposalofwaste
Toguaranteethehealthandsafetyofourstaffandtocomplywiththelawandthereg
ulationsforhandlinghazardousmaterials,regardinghealthandsafetyatwork,andto
complywithsafetyregulations,healthandsafetyrequirementsandrequirementsfor
safedisposalofwastesuchaschemicalwaste,chemicalresiduesorsolvents,the
formbelowmustbefullycompletedandsignedwheneverdevicesorfaultycompo
nentsaretobesentbacktoourfactory.
Productsorcomponentswillnotbeacceptedifthisdeclarationhasnotbeen
provided.
Device
Model: Part/Deviceno.:
Declarationfor
nonhazardous
materials
Weherebyassurethattheproductsreturned
havenotbeenusedinthelaboratoryandarenew.
havenotbeenincontactwithtoxic,corrosive,biologicallyactive,explosive,ra
dioactiveorotherhazardousmaterials.
arenotcontaminated.Thesolventsorresiduesofthesubstancespumpedhave
beenremoved.
Declarationfor
hazardousmateri
als
Inrespectoftheproductsreturned,weherebyassurethat
allsubstances(toxic,corrosive,biologicallyactive,explosive,radioactiveorother
wisehazardous)thathavebeenpumpedbytheproductsorhaveotherwisebeen
incontactwiththeproductsarelistedbelow.
theproductshavebeencleaned,decontaminated,sterilisedinsideandoutside
andallinletsandoutletsaresealed.
Listofhazardousmaterialsthathavebeenincontactwiththeproducts:
Chemical,material Hazardcategory
Finaldeclaration Weherebydeclarethat
wearefullyconversantwiththesubstancesthathavebeenincontactwiththeprod
uctsandhaveansweredallquestionscorrectly.
wehavetakenallmeasuresnecessarytopreventpotentialhazardsinrespectof
theproductsreturned.
Companynameorstamp:
Place,date:
Name(blockletters),position
(blockletters):
Signature:
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