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Repair Instructions For ASF Leak Detection Systems

 
  Prior to an expertise or repair of your returned leak detection system, a service request and a safety declaration according to EU guideline 67/548/EWG must be be sent to our service department. To ensure prompt processing of your service request, we recommend to transmit the safety declaration before actually sending your leak detection system.

Service Request And Safety Declaration According To EU Guideline 67/548/EWG

This safety declaration must be used when returning devices during warranty period or for service/repair by Gardner Denver Thomas.

To ensure prompt processing, please fill out the form below completely and carefully. When done please hit the "Send" button at the end of the form to transmit the information immediately to our service department.

If possible, please print this form and enclose it with the shipment of your leak detection device.

* = These fields must be filled out!

Customer Data / Contact:

Customer Number *

Title

First Name *

Last Name *

Company *

Address *

ZIP-Code, City *

Phone-No. *

Fax-No. *

E-Mail-Address *

Internet-Address   

Detailed information on the returned device/pump: (Please see label)

Article Number *

Serial Number *

Application *

Detailled Defect Description *
 

Does the device derive from your own production or
is it a return shipment from an end user? *
 

 From own production
From end user
 

Please answer the following questions carefully. If this is a return shipment from an end user, the end user must answer the questions!

 

Liquid/Gas Medium *

Hazard Symbols *

R/S Phrases *

Remarks:
 

Is the liquid/gas medium rated hazardous to health? *
(Pollution for example by sewage, blood or blood products, chemicals,   
biological contamination, spoilt food)
If you had to answer this question with "YES", it is imperative that you contact our facility in Memmingen by phone BEFORE you ship the device.
Phone No.: +49 (0)8331 9570-1572
 

 Ja     No
 

Has the device been cleaned prior to return shipment? *
 

 Yes     No
 

Has the device been disinfected prior to return shipment? *
 

 Yes     No
 

Has the device been sterilised prior to return shipment? *
 

 Yes     No
 
 

End User Information:

Title

First Name

Last Name

Company

Address

ZIP, City

Phone No.

Fax No.
 

Attention:

  • Devices which are rated hazardous to health according to the questions above or are not cleaned properly, MUST NOT BE RETURNED!
     
  • Radioactive contaminated devices NEVER may be returned to our facilities.

Duration of validity:

This safety declaration is valid for one year, starting with the send date. If the usage of liquid/gas medium has changed or if the safety declaration is older than one year, a new declaration has to be sent to us.

 
 

 

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