Safety Declaration - Grundfos DMH 28X Instrucciones De Instalación Y Funcionamiento

Anexo
Please copy, fill in and sign this sheet and attach it to the pump returned for service.
Fill in this document using English or German lan-
Nota
guage.
We hereby declare that this product is free from hazardous chemicals,
No media or water: _____________________________
A chemical solution, name: _________________________
In the case of an electrical or functional fault, please mark the cabinet.
Please give a short description of the fault:
_____________________
Date and signature

Safety declaration

biological and radioactive substances:
Product type: ________________________________
Model number: _____________________________
(see pump nameplate)
Fault description
Please make a circle around the damaged part.
_____________________
Company stamp
1
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