the company news history contact find us cooperations and partnerships jobs technology highly charged ions applications ion sources produced ions x-ray spectroscopy publications vacuum service electronic high vacuum fine vacuum cleanroom decontamination service contracts second hand products products my products ion sources irradiation facilities spectrometer components equipment & supplies reference facilities	Declaration of Contamination of Vacuum Equipment and Components 1. Description of component: - Equipment type/model: - Code No.: - Serial No.: - Invoice No.: - Delivery Date: 2. Reason for return: 3. Equipment condition - Has the equipment been used? yes no - What type of pump oil was used? - Is the eqipment free from potentially harmful substances? yes (go to section 5) no (go to section 4) 4. Process related contamination of equipment - toxic yes no - corrosive yes no - microbiological hazard *) yes no - explosive *) yes no - radioactive *) yes no - other harmful substances yes no *) We will not accept delivery of any equipment that has been radioactively or microbiologically contaminated without written evidence of decontamination! Please list all substances, gases and by-products which may have come into contact with the equipment: Tradename Product name Manufacturer Chemical Name (or symbol) Danger class Precautions associated with substance Action if spillage or human contact 1. 2. 3. 4. 5. 5. Legally Binding Declaration I hereby declare that the information supplied on this form is complete and accurate. The despatch of equipment will be in accordance with the appropriate regulations covering Packaging, Transportation and Labelling of dangerous substances. name of organisation: postal code, city: address: e-mail: phone: fax: name: job title: date: Company stamp: Legally binding signature:
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