Fluid Components International FLT Series - Manual (Page 57)

Doc. No. 06EN003286 Rev. - C - 3 FLTÔ Series FlexSwitchÔ
APPENDIX C - CUSTOMER SERVICE FLUID COMPONENTS INTL
Decontamination Information
Exposure to hazardous materials is regulated by Federal, state (California), County and City laws and regulations. These
laws provide FCI's employees with the right to know the hazardous materials with which they come in contact while handling
our products. Consequently, our employees must have access to data regarding the hazardous materials which the equipment
has been exposed to in your process(es). Accordingly, prior to returning your instrument for repair, please sign the certification below and
thoroughly comply with the instructions, if applicable.
I certify that the item(s) has (have) been thoroughly and completely cleaned and if the item(s) has (have) been exposed to or
contacted by a hazardous material, hazardous substance or toxic materials or substances that the undersigned can assure the returned item(s) has
(have) been thoroughly and completely decontaminated and neutralized of such substances and contamination. I have also attached a
Material Safety Data Sheet (MSDS) which covers all hazardous material, hazardous substance or toxic materials or substances
exposed to or contacted by the instrument. Furthermore, I understand that this Certificate, or providing a MSDS, shall not waive our
responsibility to provide a neutralized, decontaminated, and clean product for repair to FCI.
Authorized Signature Date
Cleanliness of a returned item or the acceptability of the MSDS shall be at the sole discretion of FCI.
Any returned item which does not comply with these instructions shall be returned to you at your expense.
Model Number(s) Serial Number(s)
Sending: Electronics only Sensor only Complete unit Number of units
Failure Symptoms
Troubleshooting done in the field by FCI representative or by Customer :
Action to be taken by FCI
(Note: Re-calibration/Re-certification requires the completion of a new Application Data Sheet)
Process Flow Media:
Who is your FCI factory technical contact:
Name of Company Returning Hardware
Contact Name: Phone # Fax #
Customer Bill to Address: Ship to:
Purchase Agent Contact: Phone # Fax #
Customer Information
Document 1.
FCI RETURN AUTHORIZATION REQUEST
Product Information
Note: FCI will charge a $100 minimum handling fee on all non-warranty evaluations.
Have you contacted your local FCI representative for assistance? yes no