Support from inficon service, 2 support from inficon service, General information – INFICON UL5000 Dry Helium Leak Detector User Manual

Page 9: Declaration of contamination

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General Information

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Support from INFICON Service

If an instrument is returned to INFICON or an authorised representative of INFICON,
please indicate whether the instrument is free of substances damaging to health or
whether it is contaminated. If it is contaminated also indicate the nature of the hazard.
INFICON must return any appliances without a Declaration of Contamination to the
sender’s address. A form for stating details as to the type of contamination is repro-
duced in

Fig. 1-1

.

A maintenance and service contract is recommended.

Fig. 1-1: Declaration of Contamination form

INFICON GmbH

Bonner Str. 498,50968 Cologne, Germany
Tel: +49 221 3474 2222 Fax: +49 221 3474 2221
www.inficon.com [email protected]

zisa01e1-a

Declaration of Contamination

Legally binding declaration:

I/we hereby declare that the information on this form is complete and accurate and that I/we will assume any further costs that may

arise. The contaminated product will be dispatched in accordance with the applicable regulations.

O rganization/company

Address

Post code, place

Phone

Fax

Email

Name

Date and legally binding signature

Company stamp

1) or not containing any amount
of

hazardous

residues that

exceed

the permissible ex-

posure limits

Process related contamination of product:

toxic

no

1)

yes

caustic

no

1)

yes

biological hazard

no

yes

2)

explosive

no

yes 2)

radioactive

no

yes

2)

other harmful substances no

1)

yes

The service, repair, and/or disposal of vacuum equipment and components will only be carried out if a correctly completed declaration has
been submitted. Non-completion will result in delay.
This declaration may only be completed (in block letters) and signed by authorized and qualified staff.

Copies:
Original for addressee - 1 copy for accompanying documents - 1 copy for file of sender

Harmful substances, gases and/or by-products

Please list all substances, gases, and by-products which the product may have come into contact with:

Trade/p roduct name

Chemical name
(or symbol)

Precautions associated
with substance

Action if human contact

Description of product

Type
Article

Number

Serial

Number

Reason

for return

Operating fluid(s) used (Must be drained before shipping.)

The product is free of any sub-
stances which are damaging to
health yes

This form can be downloaded
from our website.

2) Products thus contami-

nated will not be ac-

cepted without written
evidence of decontami-
nation!

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