Decontamination form


Dear Valued Customer:

From time to time it may be necessary to return to Pfeiffer Vacuum a product or component for repair, exchange, replacement, or refund. In order to reduce the risk of injury to personnel who handle, disassemble, clean, or repair these products, we ask that certain procedures and safeguards be followed in full.

  1. Send a completed/signed copy of this form to us by fax to 1-888-658-7983 prior to product return.
  2. Drain all oil from pump reservoirs, if applicable.
  3. Cover all openings with original protective covers and plugs or something equivalent to them.
  4. Remove all adapters, fittings, valves, splinter screens, etc. that are not an integral part of the pump or product. Pfeiffer Vacuum will not be responsible for lost or damaged items that are not an integral part of the product.
  5. Any pump listed as hazardous on the contamination sheet should be sealed in a heavy gauge plastic bag prior to packaging for return to Pfeiffer Vacuum.
  6. Package the product in a container capable of protecting the product from physical damage during shipment to Pfeiffer Vacuum.
  7. Products exposed to RADIOACTIVE MATERIAL CANNOT BE ACCEPTED BY Pfeiffer Vacuum under any circumstances.
  8. We will not accept products that have been MICROBIOLOGICALLY contaminated without written evidence of decontamination.
  9. Pfeiffer Vacuum may request from the customer, M.S.D.S.'s for unfamiliar materials.

Pfeiffer Vacuum reserves the right to return to the sender, at the sender's expense, any product found to be improperly tagged, not repairable, or beyond Pfeiffer Vacuum's cleaning capabilities.

We are sure that you share our concern for the safety of our personnel and we request your full cooperation in carrying out these few extra steps prior to returning any and all products to Pfeiffer Vacuum.

Thank you for your cooperation and your concern. Sincerely,


James Schlesinger

CONTAMINATION DATA SHEET, PLEASE FILL OUT COMPLETELY

Fields marked with an asterisk * are mandatory.

Company*
Date
Phone*
Fax
Pfeiffer Representative*
RMA*

To ensure the health and safety of our employees, and to meet regulations for safety in the workplace as well as regulations governing the handling and disposal of hazardous materials, it is essential to fully complete this form. This form must be filled out for all products that come in contact with any kind of process involving gases, chemicals, or any other hazardous or dangerous substance.

1. Send a completed/signed copy of this form to us by fax to 1-888-658-7983 prior to product return.
2. Place a second completed copy of this form on the outside of the package with the returned product.
3. The repair time will be prolonged if information is missing or if this procedure is not followed.

Part No./Model*
Serial No.*
Please describe the REASON FOR RETURN and the APPLICATION/PROCESS in which the product was used.
KNOWN MATERIALS IN CONTACT WITH THE PRODUCT ARE: PLEASE CHECK ALL APPROPRIATE SPACES
Health Hazard* Physical Hazard*
No Health Hazard
Corrosive
Carcinogen
Irritant
Toxic
Biohazard BL-1
Biohazard BL-2
Biohazard BL-3
Biohazard BL-4
 No Physical Hazard
Combustable Liquid
Flammable Gas
Oxidizer
Explosive
Unstable
Flammable Liquid or Solid
Water Reactive
Pyrophoric
List all substances, gases, chemicals, and BY PRODUCTS which may have come in contact with the product by common name or specific chemical name below. Leaving above list blank or stating none is not acceptable.*
LIST TYPE OF OIL USED IN PRODUCT*

Pfeiffer Vacuum WILL NOT ACCEPT UNDER ANY CIRCUMSTANCES ANY PRODUCT THAT HAS BEEN EXPOSED TO RADIOACTIVITY OR IS MICROBIOLOGICALLY CONTAMINATED.

LEGALLY BINDING DECLARATION
I hereby declare that the information supplied on this form is complete and accurate.
First Name*
Last Name*
Street*
ZIP/Postal code
City*
Country
E-Mail
Job title
Pfeiffer Vacuum RESERVES THE RIGHT TO RETURN TO SENDER, AT SENDERS EXPENSE, ANY PRODUCT THAT IS NOT REPAIRABLE, THAT IS BEYOND OUR CLEANING AND DECONTAMINATION CAPABILITIES, OR THAT DOES NOT HAVE A FULLY COMPLETED CONTAMINATION DATA SHEET.
ANY QUESTIONS? CALL 1-800-248-8254
 

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