Rico RIC Serie Manual Del Usuario página 126

Fill out and return to:
(please wait for a confirmation by Rico Service)
MACHINE / PRODUCT DATA
Type of machine / Model
Cause
Description of defect
DECLARATION OF DECONTAMINATION
•
For the safety of our employees and compliance with the legal requirements during handling of substances hazardous to health
and the environment, this declaration must be filled out completely and sent for each machine / product.
•
Without said declaration filled out completely, repair cannot be carried out.
•
The declaration must be sent with the shipping documents.
1. The machine / the product
has NOT come into contact with hazardous substances. In case of repair / disposal, there is no risk to people and the
environment. Go to point 3.
has come into contact with hazardous substances. Go to point 2.
Information on contamination
2.
Type of system on which the machine is installed:
And it has come into contact with the following substances subject to the requirement of labelling or dangerous to health /
environment:
Trademark
The machine / product has been washed and cleaned on the outside. Specify the decontamination method used:
3. Legally binding declaration
The undersigned hereby declares that the details given on this form are true and complete.
APPLICANT'S DETAILS
Company name:
Street:
City:
Contact person:
E-mail / tel. no.
DESTINATION
ADDRESS
COMPLETION BY RICO CUSTOMER
CARE
RMA no.
NOTES
 Druckluftanlagenbau GmbH
RIC M30S – M120S
RIC M70RD – M120D
[email protected]
Serial no.
Repair Warranty
Blocked
Other:
Chemical name
Rico Drucluftanlagenbau GmbH; Willicher Straße 22; 47489 Tönisvorst; Germany
Tel. +49 ( 0 ) 2151 9931 99 -
purchase doc. no.
Repair
Noisy
Hazardous substance class
[email protected]
126 / 126
Periodical maintenance
Motor failure
Characteristics (e.g. toxic,
flammable, corrosive)
Date
Postal
Code
Province
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