Instruction manual
K1, K3 series chillers – Installation and Operation manual
Issue 7.0 Page 19
In case of repair requirement, please complete both parts of the form, and fax to ATC
PART 1: RETURNED MATERIAL DECLARATION FORM
Returns Number: Q0_ - ___
Your Name and Address:
…………………………………………………
…………………………………………………
…………………………………………………
…………………………………………………
Your purchase order number:
…………………………………………………
Machine part number:
Machine serial number:
…………………………………………………
…………………………………………………
Collection for return to ATC – please tick one:
ATC to arrange shipment
Customer to arrange shipment
Reason for return:
…………………….………………………………………………………………………….
If faulty, list symptoms:
…………………….………………………………………………………………………….
Address for delivery of machine
(if different from 1, above):
…………………………………………………
…………………………………………………
…………………………………………………
…………………………………………………
Please note that a minimum non-refundable inspection fee of £60 will be charged on all equipment returned for repair with the exception of equipment still under warranty.
PART 2: HEALTH & SAFETY DECLARATION
Machine part number:
…………………………………………………
Machine serial number:
…………………………………………………
I, ……………………., of ……………………………………., confirm that the above unit
is free from chemical, biological or nuclear hazard and that the unit presents no physical
hazard, including electrical.
Signed and dated:
…………………………………………………
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