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Manual - Leybold Repair by Tech Services

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Head<br />

10 ⏐GA10218_0101 - 5/2002<br />

1.2 Support from LEYBOLD Service<br />

Declaration of Contamination of Compressors, Vacuum Pumps and Components<br />

The repair and / or servicing of compressors, vacuum pumps and components will be carried out only if a correctly completed declaration has been<br />

submitted. Non-completion will result in delay. The manufacturer can refuse to accept any equipment without a declaration.<br />

A separate declaration has to be copleted for every single component.<br />

This declaration may be completed and signed only <strong>by</strong> authorised and qualified staff.<br />

Customer/Dep./Institute : Reason for returning applicable please mark<br />

Address : repair chargable warranty<br />

exchange chargable warranty<br />

DKD-Calibration Factory Calibration<br />

Person to contact: restoring goods because of following reason:<br />

Phone : Fax: rent/loan for credit against exchange<br />

Order number of customer: exchange already received/arranged<br />

A. Description of the equipment (machine or component) Ancillary equipment<br />

Type :<br />

Catalogue number:<br />

Serial number:<br />

Type of oil used :<br />

B. Condition of the equipment No Yes No Contamination : No Yes<br />

1. Has the equipment been used toxic<br />

2. Drained (Product/service fluid) corrosive<br />

3. All openings sealed airtight microbiological<br />

4. Purged explosive<br />

If yes, which cleaning agent radioactive<br />

and which method of cleaning other harmful substances<br />

C. Description of processed substances (Please fill in absolutely)<br />

1. What substances have come into contact with the equipment :<br />

Trade name and / or chemical term of service fluids and substances processed, properties of the substances<br />

According to safety data sheet (e.g. toxic, inflammable, corrosive, radioactive)<br />

X Tradename: Chemical name:<br />

a)<br />

b)<br />

c)<br />

d)<br />

1. Are these substances harmful ?<br />

2. Dangerous decomposition products when thermally loaded<br />

Which :<br />

Fig. 1 Declaration of contamination form<br />

Yes No<br />

Components contaminated <strong>by</strong> microbiological, explosive or radioactive products will not be accepted without written evidence of<br />

decontamination.<br />

D. Legally binding declaration<br />

I / we here<strong>by</strong> declare that the information supplied on this form is accurate and sufficient to judge any contamination level.<br />

Name of authorised person (block letters) :<br />

_______________________________<br />

date signatur of authorised person<br />

firm stamp<br />

If equipment is returned to <strong>Leybold</strong>, indicate whether the equipment is<br />

free of substances damaging to health or whether it is contaminated. If it<br />

is contaminated also indicate the nature of the hazard. For this you must<br />

use a form which has been prepared <strong>by</strong> us which we will provide upon<br />

request or you can take from the technical documentation folder. Also you<br />

will find this declaration on our homepage: www.leybold.com under „support<br />

& download“.<br />

Please attach this form to the equipment or enclose it with the equipment.<br />

This declaration of contamination is required to comply with legal requirements<br />

and to protect our personal. <strong>Leybold</strong> must return any equipment<br />

without a declaration of contamination to the sender’s adress.<br />

Before shipping fit the yellow screw-on seals on to the connections<br />

EXHAUST Fig 3/2 and GAS BALLAST Fig 3/3.

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