Return of Edwards Equipment - Declaration
(Form HS2)
You must:
Know about all of the substances which have been used and produced in the equipment before you complete this Declaration
• Read the Procedure (HS1) on the previous page before you attempt to complete this Declaration
• Contact your supplier to obtain a Return Authorisatio n N um b e r and to obtain advice if you have any quest ions
• Send this form to your supplier before you return your equipment
Equipment model ___________________________________________
Serial Number _____________________________________________
Has the equipment been used, tested or operated?
yes
❏
Go to Section 2 no ❏ Go to Section 4
Return Authorisation Number:
FOR SEMICONDUCTOR APPLICATIONS ONLY :
Tool Reference Number ____________________________________
Process __________________________________________________
Failure Date ______________________________________________
Serial Number of
Replacement Equipment_____________________________________
SECTION 2: SUBSTANCES IN CONTACT WITH THE EQUIPMENT
Are any of the substances used or produced in the equipment
• Radioactive yes
❏
no
❏
• Biologically active yes ❏ no
❏
• Dangerous to human health and safety? yes ❏ no
❏
If you have answered 'no' to all of these questions, go to Section 4.
SECTION 3: LIST OF SUBSTANCES IN CONTACT WITH THE EQUIPMENT
Substance name Chemical
symbol
Precautions required (for example, use protective
gloves, etc.)
Action required after spillage or
human contact
1
2
3
4
5
6
Your supplier will not accept delivery of any equipment
that is contaminated with radioactive substances, unless
you:
• Decontaminate the equipment
• Provide proof of decontamination
YOU MUST CONTACT YOUR SUPPLIER FOR ADVICE
BEFORE YOU RETURN SUCH EQUIPMENT
Reason for return and symptoms of malfunction: _____________________________________________________________________________
_____________________________________________________________________________________________________________________
If you have a warranty claim:
• who did you buy the equipment from ? __________________________________________________________________________________
• give the supplier's invoice number _____________________________________________________________________________________
SECTION 5: DECLARATION
Print your name: __________________________________Print your job title: ______________________________________________
Print your organisation: ________________________________________________________________________________________________
Print your address: ________________________________________________________________________________________________
________________________________________________________________________________________________
Telephone number: _________________________________ Date of equipment delivery: ________________________________________
I have made reasonable enquiry and I have supplied accurate information in this Declaration. I have not withheld any information.
I have followed the Return of BOC Edwards Equipment Procedure (HS1) on the previous page.
Signed: _____________________________________________________ Date ____________________________________________________
SECTION 1: EQUIPMENT
SECTION 4: RETURN INFORMATION