Instr Manual: E2M28 and E2M30 Rotary Vacuum Pumps - en
Instr Manual: E2M28 and E2M30 Rotary Vacuum Pumps - en
Instr Manual: E2M28 and E2M30 Rotary Vacuum Pumps - en
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Form HS2<br />
Return of BOC Edwards Equipm<strong>en</strong>t - Declaration<br />
Return Authorisation Number:<br />
You must:<br />
• Know about all of the substances which have be<strong>en</strong> used <strong>and</strong> produced in the equipm<strong>en</strong>t before you complete this Declaration<br />
• Read the Return of BOC Edwards Equipm<strong>en</strong>t - Procedure (HS1) before you complete this Declaration<br />
• Contact BOC Edwards to obtain a Return Authorisation Number <strong>and</strong> to obtain advice if you have any questions<br />
• S<strong>en</strong>d this form to BOC Edwards before you return your equipm<strong>en</strong>t<br />
Equipm<strong>en</strong>t/System Name_________________________<br />
Part Number _________________________________<br />
Serial Number_________________________________<br />
Has the equipm<strong>en</strong>t be<strong>en</strong> used, tested or operated <br />
YES R Go to Section 2 NO R Go to Section 4<br />
IF APPLICABLE:<br />
Tool Refer<strong>en</strong>ce Number_________________<br />
Process ______________________________<br />
Failure Date___________________________<br />
Serial Number of<br />
Replacem<strong>en</strong>t Equipm<strong>en</strong>t_________________<br />
SECTION 2: SUBSTANCES IN CONTACT WITH THE EQUIPMENT<br />
Are any substances used or produced in the equipm<strong>en</strong>t:<br />
• Radioactive, biological or infectious ag<strong>en</strong>ts, mercury,<br />
poly chlorinated biph<strong>en</strong>yls (PCBs), dioxins<br />
or sodium azide (if YES, see Note 1) YES R NO R<br />
• Hazardous to human<br />
health <strong>and</strong> safety<br />
SECTION 1: EQUIPMENT<br />
YES R NO R<br />
Note 1 : BOC Edwards will not accept delivery of any<br />
equipm<strong>en</strong>t that is contaminated with radioactive substances,<br />
biological/infectious ag<strong>en</strong>ts, mercury, PCB’s, dioxins or<br />
sodium azide, unless you:<br />
• Decontaminate the equipm<strong>en</strong>t<br />
• Provide proof of decontamination<br />
YOU MUST CONTACT BOC EDWARDS FOR ADVICE<br />
BEFORE YOU RETURN SUCH EQUIPMENT<br />
SECTION 3: LIST OF SUBSTANCES IN CONTACT WITH THE EQUIPMENT<br />
Substance name<br />
Chemical<br />
Symbol<br />
Precautions required (for example,<br />
use protective gloves, etc.)<br />
Action required after a spill,<br />
leak or exposure<br />
SECTION 4: RETURN INFORMATION<br />
Reason for return <strong>and</strong> symptoms of malfunction _________________________________________________<br />
_________________________________________________________________________________<br />
If you have a warranty claim:<br />
• who did you buy the equipm<strong>en</strong>t from _____________________________<br />
• give the supplier’s invoice number_________________________________<br />
SECTION 5: DECLARATION<br />
Print your name:_________________________________Print your job title:_________________________<br />
Print your organisation:____________________________________________________________________<br />
Print your address:_______________________________________________________________________<br />
_______________________________________________________________________<br />
Telephone number: ___________________________Date of equipm<strong>en</strong>t delivery: ______________<br />
I have made reasonable <strong>en</strong>quiry <strong>and</strong> I have supplied accurate information in this<br />
Declaration. I have not withheld any information, <strong>and</strong> I have followed the Return of<br />
BOC Edwards Equipm<strong>en</strong>t - Procedure (HS1).<br />
Signed: _____________________________________Date______________<br />
Note: Please print out this<br />
form, sign it <strong>and</strong> return the<br />
signed form as hard copy.<br />
P900-71-000 Issue K