Declaration of Contamination

This form serves for the submission of your contaminated device. Please make sure to fill in this form as detailed as possible. After having submitted this form, you will receive a summary as PDF which you can add to your device for shipment.

1. Declaration of Contamination of the evaporator
2. Declaration of Contamination of the control unit.
3. Contact

Fields marked with * are mandatory.

I/we hereby confirm that the information provided in this form is correct and complete. The contaminated units will be shipped in compliance with the legal requirements.