
SS0478 Rev G
MODEL 206
Industrial Pressure Transducer
OPERATING INSTRUCTIONS
7.0 RETURN OF SETRA SYSTEMS PRODUCT-DECLARATION
(Form 206ERN)
EXPECTED RETURN NUMBER _______________________________________________
You must:
• Know about all of the substances which have been used and produced in the
product before you complete this Declaration.
• Contact your supplier if you have any questions and for an ERN Number.
• Send this form to your supplier with the return of the product.
SECTION 1: Product
A. Model Number _____________________
B. Serial Number ______________________
C. Has the product been used, tested or operated?
Yes - Go to Section 2 No - Go to Section 4
SECTION 2: Substances in Contact with the Product
A. Radioactive* Yes No
B. Biologically Active Yes No
C. Dangerous to Human Health and Safety? Yes No
* Note: Your supplier will not accept delivery of any products that are contaminated
with radioactive substances, unless you:
• Decontaminate the products
• Provide proof of decontamination
YOU MUST CONTACT YOUR SUPPLIER FOR ADVICE BEFORE YOU RETURN SUCH PRODUCTS
If you have answered “no” to all of these questions, go to Section 4.
SECTION 3: List of Substances in Contact with the Product
SECTION 4: Return Information
Reason for return and symptoms of malfunction: ______________________________
_______________________________________________________________________
If you have a warranty claim:
• Who did you buy the product from?: _______________________________________
• Give the supplier’s invoice number or your purchase order number: ______________
SECTION 5: Declaration
Print your Name: _______________________ Print Your Job Title: ________________
Print Your Company Name: ________________________________________________
Print Your Address: _______________________________________________________
Telephone Number: ____________________ Date of Product Return:_____________
I have made reasonable inquiry and I have supplied accurate information in this
Declaration. I have not withheld any information. I have followed the Return of Setra
Systems Product Procedure.
Signed: ______________________________ Date: ___________________
Substance Name Chemical
Symbol
Precautions Required (eg: use
protective gloves, etc.)
Actions Required After
Spillage or Human Contact
1.
2.
3.
4.
5.
6.
159 Swanson Road
Boxborough, MA USA
Toll Free: 800-257-3872 | 978-263-1400
Fax: 978-264-0292
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