Product Cleanliness and Decontamination Merci de nous envoyer le formulaire.

Question Question

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Veuillez fournir les informations suivantes :

Nom de la société*

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Nom du contact*

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Adresse (Rue)*

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Ville*

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Région*

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Code postal*

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RMA#*

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Numéro de téléphone*

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Fax Number

Adresse courriel*

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Describe the location or application where the equipment was installed (e.g., golf course, lake, forest, power plant).

Describe the environmental conditions to which the equipment was exposed (e.g., sewer, stagnant water, herbicides, radioactivity).

Avez-vous nettoyé et décontaminé l'équipement ?

YES Fill out the rest of the form NO, not required. Equipment was used in an environment free from health and safety concerns. Sign document below

Describe how the equipment was cleaned and decontaminated.

List all substances of concern to which the equipment has been, or potentially has been, exposed (attach MSDS sheets, if any).

I hereby certify that the returned equipment has been cleaned and decontaminated according to good industrial practices and is in compliance with relative regulations, or "as is" this equipment poses no health or safety risks to the recipient.

Signature*

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(signer en tapant votre nom)

Une copie de ce formulaire sera envoyé à l'adresse électronique indiquée ci-dessus.

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