Decontamination Declaration Measurement for FAX: +49 89 ......E-Mail: [email protected] page 1...
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NATEC Sensors GmbH – Sitz der Gesellschaft: Garching – Handelsregister: Amtsgericht München HRB 152634 Geschäftsführer: Günter Ries Niels-Bohr-Straße 9-11, 85748 Garching, Telefon +49 89 307591-0, Fax +49 89 307591-29 Decontamination Declaration FAX: +49 89 307591-29 or E-Mail: [email protected] page 1 from 2 (Version 4.3) Due to legal requirements and to protect our employees, we ask you to sign the "Decontamination Declaration". Please take into ATTENTION: Without your complete declaration of decontamination we cannot start the working process! Please fill out, sign this form and send it to us in advance by fax or email or fasten a copy well visible at the OUTSIDE of the package. delivery address: NATEC Sensors GmbH Niels-Bohr-Straße 9-11 D-85748 Garching for questions: phone +49 89 307 591-0 fax +49 89 307 591-29 e-mail [email protected] Information to the sender (contact for queries): company phone contact person fax street or postbox e-mail address your order number serial number: Information to your device (please note all devices of the shipment): model: model: serial number: model: serial number: radioactive flammable toxic corrosive Information to your operation/application: medium (please specify) during process final cleaning with harmfull / others harmless irritant during process final cleaning with Measurement for Humidity Pressure Torque Force Flow
Transcript of Decontamination Declaration Measurement for FAX: +49 89 ......E-Mail: [email protected] page 1...
NATEC Sensors GmbH – Sitz der Gesellschaft: Garching – Handelsregister: Amtsgericht München HRB 152634 Geschäftsführer: Günter Ries
Niels-Bohr-Straße 9-11, 85748 Garching, Telefon +49 89 307591-0, Fax +49 89 307591-29
Decontamination DeclarationFAX: +49 89 307591-29 orE-Mail: [email protected]
page 1 from 2 (Version 4.3)
Due to legal requirements and to protect our employees, we ask you to sign the "Decontamination Declaration". Please take into ATTENTION: Without your complete declaration of decontamination we cannot start the working process! Please fill out, sign this form and send it to us in advance by fax or email or fasten a copy well visible at the OUTSIDE of the package.
delivery address: NATEC Sensors GmbH Niels-Bohr-Straße 9-11 D-85748 Garching
for questions: phone +49 89 307 591-0 fax +49 89 307 591-29 e-mail [email protected]
Information to the sender (contact for queries):
company phone
contact person fax
street or postbox e-mail
address your order number
serial number:
Information to your device (please note all devices of the shipment):
model:
model: serial number:
model: serial number:
radioactive flammable toxic corrosive Information to your operation/application:
medium (please specify)
during process
final cleaning with
harmfull / others harmless irritant
during process
final cleaning with
Measurement for Humidity Pressure Torque Force Flow
NATEC Sensors GmbH – Sitz der Gesellschaft: Garching – Handelsregister: Amtsgericht München HRB 152634 Geschäftsführer: Günter Ries
Niels-Bohr-Straße 9-11, 85748 Garching, Telefon +49 89 307591-0, Fax +49 89 307591-29
Customer requests FAX: +49 89 307591-29 or E-Mail: [email protected]
page 2 from 2 (Version 4.3)
Customer specifications (please mark the fields which you wish):
analyses modification check
ISO-calibration DAkkS-calibration as-found-calibration
maintanance repair
We would like NATEC Sensors GmbH to dispose defective devices and associated components (cables, plugs)
from this delivery for us.
Additional information, if applicable description failure:
Operating data:
customer application
measuring range
medium
temperature °C
viscosity mm²/s
density kg/m³
pressure bar gauge pressure absolute pressure differential pressure
Your reference date for the re-shipment:
Address for invoice/delivery address (if different from the sender):
phone company
contact person fax
street or postbox e-mail
address your order
We confirm to have filled out this declaration completely and truthfully to the best of our knowledge.
place / date name / department signature
Measurement for Humidity Pressure Torque Force Flow
