KNAMM-05

Richter™
Operating Instructions For
Ball Valves
Series KNA/KNAP
This manual provides installation and maintenance instructions for RICHTER manual and
pneumatically operated Series KNA ball valves. If additional information is required, contact:

ITT Industries, Industrial & BioPharm Group

33 Centerville Road
Lancaster, PA 17603
(717) 509-2200
FAX: (717) 509-2336
Attention: Sales Department

Warning
ITT INDUSTRIES VALVES AND VALVE ACTUATORS ARE DESIGNED AND MANUFACTURED USING
GOOD WORKMANSHIP AND MATERIALS, AND THEY MEET ALL APPLICABLE INDUSTRY STANDARDS.
THESE VALVES ARE AVAILABLE WITH COMPONENTS OF VARIOUS MATERIALS, AND THEY SHOULD
BE USED ONLY IN SERVICES RECOMMENDED IN OUR PRODUCT CATALOG OR BY A COMPANY
VALVE ENGINEER.
MISAPPLICATION OF THE PRODUCT MAY RESULT IN INJURIES OR PROPERTY DAMAGE. A
SELECTION OF VALVE COMPONENTS OF THE PROPER MATERIAL CONSISTENT WITH THE
PARTICULAR PERFORMANCE REQUIREMENT, IS IMPORTANT FOR PROPER APPLICATION.
EXAMPLES OF THE MISAPPLICATION OR MISUSE OF ITT INDUSTRIES VALVES INCLUDE USE
IN AN APPLICATION IN WHICH THE PRESSURE/ TEMPERATURE RATING IS EXCEEDED OR FAILURE
TO MAINTAIN VALVES AS RECOMMENDED.
IF VALVE EXHIBITS ANY INDICATION OF LEAKAGE, DO NOT OPERATE. ISOLATE VALVE AND
EITHER REPAIR OR REPLACE.

Keep for future use!

This operating manual must be
strictly observed before transport,
installation, commissioning etc. in
order avoid endangering.
Subject to change without notice.
Reproduction is generally permitted
with indication of the source.
© ITT Richter Chemie-Technik
GmbH
Installation and Operating Manual Series KNA, KNAP, KNA-S, KNAP-S, ASME/ANSI

List of Contents

1 Technical data..................................... 3 7 Operation .............................................9

1.1 Intended use.............................................3 7.1 Initial commissioning ................................9
1.2 Name plate, CE and body markings.........4 7.2 Inadmissible modes of operation and their
1.3 Tightening torques....................................4 consequences ..........................................9
1.4 Breakaway torques...................................4 7.3 Shutdown..................................................9
1.5 Flow rates .................................................5
1.6 Pressure-temperature-diagrams ..............5 8 Malfunctions......................................10

2 Notes on safety................................... 6 9 Maintenance ......................................10

2.1 Inadmissible modes of operation ...........6 9.1 Dismantling.............................................10
9.1.1 KNA, KNA-S with lever 10
3 Safety notes for applications in 9.1.2 Packing bellows 10
9.1.3 KNAP, KNAP-S with actuator 10
potentially explosive areas based on the
9.2 Assembly................................................11
Directive 94/9/ EC (ATEX 95).............. 7
9.2.1 Packing bellows 11
3.1 Intended use.............................................7 9.2.2 KNA, KNA-S with lever 11
9.2.3 KNAP, KNAP-S with actuator 11
4 Safety note for valves, certified to Clean 9.3 Conversion from lever to actuator ..........11
Air Act (TA-Luft) .................................. 8
10 Drawings............................................12
5 Transport and storage ....................... 8 10.1 Sectional drawing KNA with lever...........12
5.1 Storage.....................................................8 10.2 Sectional drawing KNAP with actuator ...13
5.2 Return consignments ...............................8

6 Installation........................................... 9
6.1 Flange caps and gaskets .........................9
6.2 Direction of flow and installation position .9
6.3 Grounding.................................................9
6.4 Test pressure ...........................................9

Relevant documents
♦ Declaration of conformity acc. to the EC Pressure ♦ Depending on option, relevant drawing:
Equipment Directive 97/23/EG
Double packing bonnet 9520-00-0002
♦ Form for General Safety Certificate Extended stem 9520-00-0003
QM 0912-16-2001_en
Extended stem, round 9520-00-0019
♦ For KNAP, KNAP-S: Operating manual for actuator Lever elevation 9520-00-0004
♦ Option double packing bonnet: Limit switch IFM 9520-00-0006
Supplementary Installation and Operating Manual for Limit switch VDE/VDI 9520-00-0008
double packing bonnet 9520-055-en Spring return unit Kinetrol 9520-00-0007
Initiator Turck 9520-00-0011
Locking plate 9520-00-0009
Heating jacket 9520-00-0015

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1 Technical data
Manufacturer: Ball valve sizes in inch :
ITT Richter Chemie-Technik GmbH KNA, KNAP: ½“, ¾“, 1“, 1½“, 2“, 3“, 4“ 6“
Otto-Schott-Str. 2 8“ with reduced passage 6"
D-47906 Kempen KNA-S, KNAP-S: 1“, 1½“, 2“
Phone: +49 (0) 2152 146-0 Fax: +49 (0) 2152 146-190
Email: [email protected] Website: www.itt-richter.de Installation position :
Arbitrary, with low-cavity ball/stem units a direction arrow
Designation : indicates the direction of flow.
Ball valve with ball/stem unit and Richter ENVIPACK See Sections 6.2 and 10.2.
universal packing, two-piece body.
Series Dimensions and individual parts:
KNA Design with lever or hand gear See sectional drawings in Section 10.
KNAP Design prepared for pneum., hydr. or electric
actuator to DIN/ISO 5211
Wear parts: Seat rings
Packing components
KNA-S Stainless steel ball valve with lever, Ball/stem unit
FDA conform wetted materials
KNAP-S Design prepared for pneum., hydr. or Options :
elecectric actuator to DIN EN ISO 5211 Richter ENVIPACK double packing
Certified to Clean Air Act (TA-Luft) for particularly high safety requirements, self-adjusting.
On request, monitoring and flushing connection.
Tightness tested to DIN EN 12266-1
Ball/stem unit extension for insulated pipes.
Face to face: ASME/ANSI B16.10, Class 150
to 6“ column 19 Hand lever extension depending on requirements.
8“ column 18 Limit switches
Flange connecting dimensions: for remote monitoring of hand and remote-activated ball
ASME/ANSI B16.5 Class 150, raised face. valves.
Testing for valves DIN EN 12266-1. Lockable hand lever
to prevent unauthorised operation.
Materials :
Body material: Stainless steel heating jacket
can be retrofitted, suitable for all common heat carriers.
KNA, KNAP: Ductile cast iron EN-JS 1049 to DIN EN
1563 (0.7043 DIN 1693) or ASTM A395
KNA-S, KNAP-S: 316 investment cast, CF8M (1.4408) 1.1 Intended use
Lining material: PFA or FEP
on request : conductive design Ball valves are open/closed valves.
Richter ball valves of the series KNA, KNAP, KNA-S and
Temperature range : KNAP-S are pressure containing components in
See pressure-temperature diagram in Section 1.6. accordance with the Pressure Equipment Directive (PED)
for the passage and shut-off of fluids. The valves are
Operating pressure: suitable for vapours, gases and non-boiling liquids of
½“ – 6“ from vacuum to max.275 psig (19 bar)
group 1 according to the PED and have a corrosion-
8“/6" max. 145 psig (10 bar)
resistant plastic lining.
Weight, KNA, KNA-S manually operated: Solids can lead to increased wear, damage to sealing
Nom. surfaces or to a reduction in the service life of the valve.
size
½“ ¾“ 1“ 1½“ 2“
The operator must carefully examine in the event of
kg 5,6 6 5,6 12 14,5 operating data other than those provided whether the
lbs 12.3 13.2 12.3 26.4 31.9 designs of the valve, accessories and materials are
Nom.
suitable for the new application (consult the manufac-
size
3“ 4“ 6“ 8“/6" turer).
kg 33,5 50 91 125 Ball valves of the series KNA-S and KNAP-S can be used
in a corrosive atmosphere and in clean-room conditions.
lbs 73.7 110 200 275

For weight of actuator, see actuator manufacturer's

manual.
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1.2 Name plate, CE and body Pipe screws

markings Flanges Tightening

nom. size Screws torque
The stainless steel name plate is firmly riveted to the [inch] [ASME/ANSI] [Nm]
body. ½“ 4 x ½“ 10
If the operator attaches his identification, it must be ¾“ 4 x ½“ 10
ensured that the valve matches the application in 1“ 4 x ½“ 10
question.
1½“ 4 x ½“ 20
Example of name plate with CE marking: 2“ 4 x 5/8“ 30
3“ 8 x 5/8“ 50
4“ 8 x 5/8“ 30
6“ 8 x ¾“ 55
8“ 8 x ¾“ 75

Body screws
Tightening
Nom. size Screws torque
[inch] [ISO/DIN] [Nm] [in-lbs]
½“ 4 x M12 35 310
¾“ 4 x M12 35 310
1“ 4 x M12 35 310
1½“ 4 x M16 45 398
No CE marking is permissible for the sizes ½“, ¾“ and 1"; 2“ 4 x M16 45 398
the name plate therefore has no CE marking. 3“ 8 x M16 50 442
4“ 6 x M20 100 885
Body identification : 6“ 8 x M20 100 885
The following are visible on the body according to DIN EN 8“ 8 x M20 100 885
19 and AD 2000 A4:
♦ Nominal size
♦ Rated pressure 1.4 Breakaway torques
♦ Body material Test medium: water 68 °F (20 °C)
♦ Manufacturer's identification Higher breakaway torques may occur with other media.
♦ Melt number/Foundry identification DN ∆p in bar
♦ Foundry date max.
3 6 10 16
adm.
[inch] [in-lbs] [in-lbs] [in-lbs] [in-lbs] [in-lbs]
1.3 Tightening torques ½“ 71 71 71 88 620
All screws greased, tighten in diametrically opposite ¾“ 71 71 71 88 620
sequence! 1“ 106 106 106 106 620
The tightening torques for pipe screws and body screws 1½“ 177 177 177 221 1991
mentioned must not be exceeded. For an exception, see 2“ 221 221 221 265 1991
Section 8, Flange connection valve / pipe is leaking.
3“ 531 531 575 708 4425
The following tightening torques are recommended: 4“ 708 708 796 1504 4425
. .
Packing screws 6“ 1770 2212 3097 / 19470
. .
The pretension has been reached when the spring gland 8“/6" 1770 2212 3097 / 19470
follower is bent horizontally. 1 in-lb = 0.112 Nm

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1.5 Flow rates Acc. to ASME B 16.42

Nom. size kv100 kv100

3
[inch] [m /h] [US gpm]
½“ 17,2 20
¾“ 30,9 36
1“ 60 70
1½“ 190 221
2“ 280 326
3“ 587 684
4“ 1250 1456
6“ 2800 3262
8“/6" 3200 3728

1.6 Pressure-temperature-diagrams

When used in the area of application of ASME/ANSI,

the low temperature of ASTM A395 is limited to -20°F (-
29°C).

When used in the minus temperature range,

the regulations applicable in the country in
question must be observed.

A special material is used for the ball/stem unit for

operating limits under – 10 °C to – 60 °C.

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2 Notes on safety
This operating manual contains fundamental information When using the valve, it must be ensured that
which is to be observed during installation, operation and ♦ actuators which are retrofitted are adapted to suit the
maintenance. It must therefore be read before installation valve
and commissioning.
♦ hot or cold valve parts are protected by the customer
Installation and operation are to be performed by qualified against being touched
staff. ♦ the ball valve has been properly installed in the pipe
The area of responsibility, authority and supervision of the system
staff must be regulated by the customer. ♦ the usual flow rates are not exceeded in continuous
operation.
General hazard symbol!
People may be put at risk. This is not the manufacturer's responsibility.
Ball valves which are used as end valves must
Safety symbol! The ball valve and its function be sealed with a blind flange at the free
may be put at risk if this safety symbol is not connection end or appropriately secured against
observed. unauthorised activation.
Fire protection to DIN EN ISO 10497 is not possible
It is imperative to observe warnings and signs attached
(plastic lining and plastic components).
directly to the ball valve and they are to be kept fully
legible.
Non-observance of the notes on safety may result in
the loss of any and all claims for damages. 2.1 Inadmissible modes of
For example, non-observance may involve the following operation
hazards:
The operational reliability of the valve supplied is only
♦ Failure of important functions of the valve/plant. guaranteed if it is used properly in accordance with
♦ Risk to people from electric, mechanical and chemical Section 1.1 of this operating manual.
effects. The operation limits specified on the identifica-
♦ Risk to the environment through leaks of hazardous tion plate and in the pressure-temperature
substances. diagram must under no circumstances be
exceeded.

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3 Safety notes for applications in potentially explosive areas based

on the Directive 94/9/ EC (ATEX 95)
The valves are intended for use in a potentially explosive
area and are therefore subject to the conformity 1. Chargeable liquid and non-conductive lining
assessment procedure of the directive 94/9/EC (ATEX). Charges can occur on the lining surface. As long as
As part of this conformity assessment, an ignition hazard the valve is completely filled with medium, no
analysis to EN 13463-1 to satisfy the fundamental safety hazardous discharges can result from these charges.
and health requirements was conducted with the following As a result, this can produce discharges inside the
result: valve. However, these discharges cannot cause
♦ The valves do not have any ignition source of their ignitions if the valve is completely filled with medium.
own and can be operated both manually as well as If the valve is not completely filled with medium, e.g.
mechanically/electrically. during evacuation and filling, the formation of an
♦ The valves are not covered by the scope of explosive atmosphere must be prevented, e.g. by
application of the ATEX directive and therefore do superimposing a layer of nitrogen.
not need to be identified accordingly. It is recommended to wait 1 hour before removing the
valve from the plant in order to permit the elimination
♦ The valves may be used in a potentially explosive of static peak charges.
area.
This means that, to safely prevent ignitions, the valve
Supplementary notes: must be completely filled with medium at all times or
♦ Electric/mechanical actuators must be subjected else a potentially explosive atmosphere must be
excluded by superimposing a layer of inert gas.
to their own conformity assessment to ATEX.
It is imperative to observe the individual points of intended
2. Chargeable liquid and conductive lining
use for application in a potentially explosive area.
No hazardous charges can occur as charges are
discharged direct via the lining and shell (surface
9 6
resistance < 10 Ohm, leakage resistance < 10 Ohm).
3.1 Intended use Static discharges of non-conductive linings are
Inadmissible modes of operation, even for brief only produced through the interaction with a non-
periods, may result in serious damage to the unit. conductive medium and are therefore the respon-
In connection with explosion protection, potential sibility of the plant operator.
sources of ignition (overheating, electrostatic and Static discharges are not sources of ignition which
induced charges, mechanical and electric sparks) stem from the valves themselves!
may result from these inadmissible modes of The temperature of the medium must not exceed the
operation; their occurrence can only be prevented by temperature of the corresponding temperature class or
adhering to the intended use. the maximum admissible medium temperature as per
Furthermore, reference is made in this connection to the the operating manual.
Directive 95/C332/06 (ATEX 118a) which contains the If the valve is heated (e.g. heating jacket), it must be
minimum regulations for improving the occupational ensured that the temperature classes prescribed in the
health and safety of the workers who may be at risk from Annex are observed.
an explosive atmosphere. To achieve safe and reliable operation, it must be
A difference is made between two cases for the use of ensured in inspections at regular intervals that the unit
-8
chargeable liquids (conductivity < 10 S/m): is properly serviced and kept in technically perfect
order.
Increased wear to the valve can be expected with the
conveyance of liquids containing abrasive constitu-
ents. The inspection intervals are to be reduced com-
pared with the usual times.
Actuators and electric peripherals, such as tempera-
ture, pressure and flow sensors etc., must comply with
the valid safety requirements and explosion protection
provisions.

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The valve must be grounded. Special attention must be paid to the appropriate
This can be achieved in the simplest way via the pipe safety and explosion protection notes in the respective
screws using tooth lock washers. operating manuals.
Otherwise grounding must be ensured by other action, Plastic-lined valves must not be operated with carbon
e.g. cable bridges. disulphide.
Attachments such as actuators, position controllers,
limit switches etc. must satisfy the relevant safety
regulations as regards explosion protection and, if
required, be designed in compliance with Atex.

4 Safety note for valves, certified to Clean Air Act (TA-Luft)

Certificate / Manufacturer Declaration Validity is In particular, servicing must be conducted at regular
dependent on the operating instructions being read and intervals, and the bolted connections relevant for
observed. tightness must be inspected and retightened if necessary.

5 Transport and storage

It is imperative, for all transport work, to observe
generally accepted engineering practice and the
5.2 Return consignments
accident prevention regulations. Valves which have conveyed aggressive or toxic
The valve is supplied with flange caps. Do not remove media must be well rinsed and cleaned before
them until just before installation. They protect being returned to the manufacturer's works.
the plastic surfaces against dirt and mechanical
damage. A General Safety Certificate on the field of application is
Handle the goods being transported with care. During to be enclosed with the returned goods.
transport the valve must be protected against impacts and Pre-printed forms are enclosed with the installation and
collisions. operating manual.
Directly after receipt of the goods, the consignment must Safety precautions and decontamination measures are to
be checked for completeness and any in-transit damage. be mentioned.
Do not damage paint protection.

5.1 Storage
If the valve is not installed immediately after delivery, it
must be put into proper storage.
It should be stored in a dry, vibration-free and well-
ventilated room at as constant a temperature as possible.

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6 Installation
Examine valve for in-transit damage, damaged ball valves
must not be installed.
6.2 Direction of flow and installation
Before installation the valve and the connecting pipe must position
be carefully cleaned to remove any dirt, especially hard
Installation is independent of the direction of flow.
foreign matter.
Any installation position can be chosen.
During installation, pay attention to the correct tightening
torque, aligned pipes and tension-free assembly. Otherwise, it is marked by a direction arrow on the ball
valve, e.g. in the case of cavity-free ball/stem units.
Ensure that a remotely actuated actuator cannot
be accidentally switched on.
6.3 Grounding
If the plant requires grounding the easiest solution is to
6.1 Flange caps and gaskets place a toothed lock washer under the nut of a pipeline
bolt of each valve flange.
Leave protective caps on the flanges until just prior to Otherwise grounding must be ensured by different
installation. measures e.g. a cable link.
The ball/stem unit is grounded using a grounding spring
Where there is a particularly high risk of damage to the washer 557.
plastic sealing surfaces, e.g. if the mating flanges are
made of metal or enamel, PTFE-lined gaskets with a
metal inlay should be used. These gaskets are available 6.4 Test pressure
as special accessories in the ITT Richter range.
The test pressure PT of an open valve must not exceed
the value of 1.5 x PS(PN) as per the identification of the
valve.

7 Operation
7.1 Initial commissioning ♦ If the ball blocks, do not apply force as the ball/stem
unit may break if the max. adm. torque is exceeded.
Normally, the ball valves have been tested for leaks with ♦ Operation with solids leads to increased wear.
air or water. Prior to initial operation check body bolting. ♦ Operating during cavitation leads to increased wear.
For torques see Section 1.3.
♦ Non-observance of the pressure-temperature diagram
Unless otherwise agreed, there could be can lead to damage.
residual amounts of water in the flow section of ♦ Do not subject the handwheel to heavy loads; the
the ball valve; this could result in a possible handwheel or ball valve may be damaged.
reaction with the medium.
♦ Do not use a lever extension as otherwise there is a
To prevent leaks, all connection screws should be risk of damage.
retightened after the initial loading of the valve with
operating pressure and operating temperature.
For torques see Section 1.3. 7.3 Shutdown
The local regulations are to be observed when disman-
7.2 Inadmissible modes of operation tling the valve.
and their consequences Prior to undoing the flange connection ensure, that the
plant is depressurised and emtied.
♦ The ball valve is an open/closed valve and is not to be Prior to starting any repair work, the valve is to
operated in an intermediate position. be thoroughly cleaned. Even if the valve has
Damage to the seat rings or the ball/stem unit could been properly emtied and rinsed, residual
occur. medium may still be found in the valve,
♦ Crystallisation may result in damage to the seat rings After dismantling, immediately protect the valve flanges
or ball/stem unit. This can be prevented by heating. against mechanical damage with flange caps. See also
♦ In extreme cases this may cause blocking. Section 6.1.
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8 Malfunctions
♦ Flange connection ball valve/pipe is leaking ♦ The ball no longer closes completely
Retighten the flange screws to a tightening torque Is the stem deformed?
according to Section 1.3. If this does not remedy the Is the coupling worn?
leak, the recommended torques may be exceeded by
10%. With a worm gear or actuator, check whether the end
If this also fails to stop the leak, dismantle and inspect stops can be re-adjusted. The operating manuals of
the ball valve. the gear and actuator manufacturers contain accurate
instructions.
♦ Flange connection main body/body end piece is Never apply force to the lever or use an
leaking extension.
Retighten body screws. See paragraph "Flange con-
nection ball valve/pipe is leaking". 1. Try to get the ball valve working again by moving
the lever to and fro.
♦ Packing is leaking
2. Remove the lever stop and try to switch against the
Retighten packing nuts according to the details in normal direction of rotation.
Section 1.3. 3. If activation is not possible with the max. admissible
♦ Ball valve does not operate breakaway torque as per Section 1.4, dismantle
ball valve and inspect individual components.
Is the actuator being supplied with power?
Is any directional control valve connected correctly?
Is there any foreign matter in the ball valve?

9 Maintenance
Spare parts are to be ordered with all the details in acc. 9.1.2 Packing bellows
with the valve identification.
Only original spare parts may be installed. Remove retaining washer 526.
To prevent leaks, a regular check of the connection Separate thrust ring 405/1 and packing bellows
screws should be made in line with the operating 403 by pushing them apart.
requirements.
For torques see Section 1.3.
9.1.3 KNAP, KNAP-S with actuator
9.1 Dismantling Remove actuator 850 and coupling 804.
Dismantle packing gland follower 503 and spring
9.1.1 KNA, KNA-S with lever gland follower 502.
Remove bracket 510.
Remove lever 203.
Further dismantling is performed as described in
Take out grounding spring washer 557. Section 9.1.1.
Dismantle packing gland follower 503 and spring gland
follower 502.
The thrust ring 405/1, packing bellows 403 and
retaining washer 526 (not in DN 150 and DN 200) are
one unit and it is levered out using 2 screwdrivers.
Undo screw connection body end piece 102 / main
body 100.
Remove body end piece 102.
Remove ball/stem unit 201 in closed position. Pay
attention so as not to damage the body lining.
Remove seat rings 401.

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9.2 Assembly 9.2.3 KNAP, KNAP-S with actuator

Prior to assembly all parts are to be cleaned and the Mount spring gland follower 502 and packing
plastic-lined components checked for damage. gland follower 503. Tighten packing nuts until
Insert seat rings 401 in the main body 101 and body there is no gap between packing gland follower
end piece 102. and spring gland follower. See Section 1.3 and
Mount ball/stem unit 201 in closed position. Pay 10.
attention so as not to damage the body lining. Mount bracket 510.
An additional bore in the ball/stem unit, e.g. to ensure it The opening of the bracket lies in the pipe axis.
is cavity-free, must lie on the p1 side in the closed Mount coupling 804 and actuator 850. Observe
position. the actuator position in accordance with the
Mount body end piece 102. Tighten the body screws to actuator operating manual.
a tightening torque according to Section 1.3 in diamet- Observe the ball/stem position in accordance
rically opposite sequence. with the position of the actuator.

9.2.1 Packing bellows 9.3 Conversion from lever to

actuator
Press thrust ring 405/1 into packing bellows 403.
Install retaining washer 526 (not in DN 150 and DN Select the actuator in accordance with the
200). instructions of the actuator manufacturer.
Press unit into body end piece 102. Remove lever 203.
Press in grounding spring washer 557. Remove lever stop 577 and plug.
Check the fits of the coupling 804, bracket 510
and actuator 850.
9.2.2 KNA, KNA-S with lever Observe the following during assembly of the
bracket 510:
Mount lever stop 577, spring gland follower 502 and The opening of the bracket lies in the pipe axis.
packing gland follower 503. Tighten packing nuts until Mount coupling 804 and actuator 850. Observe
there is no gap between packing gland follower and the actuator position in accordance with the
spring gland follower. See Section 1.3 and 10. actuator operating manual.
Seal any tapped bores still open with plugs.
Mount lever 203.

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10 Drawings
10.1 Sectional drawing KNA, KNA-S with lever

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10.2 Sectional drawing KNAP, KNAP-S with actuator

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Return to: ITT Industries, Industrial & BioPharm Group
Fax: 717-509-2336

G E NE RAL S AFE TY CE RTI FI CATE

For Order no: _______________________________

ITT Richter serial No. _______________________________

We herewith declare that the equipment mentioned below is being returned for inspection/repair.

Type: _______________________________

No.: _______________________________

Reason for inspection/repair:

_________________________________________________________________________________________________

_________________________________________________________________________________________________

The equipment was used for the following fluids (details according to safety data sheets as per
91/155/EEC: (Always indicate the last product conveyed.)

_________________________________________________________

_________________________________________________________

The equipment was carefully emptied and cleaned both inside and outside prior to dispatch/return:

Yes No

The following safety precautions as regards rinsing fluids, residual fluids and waste disposal are required
(indicate decontamination agent):

_________________________________________________________

_________________________________________________________

_________________________________________________________

We herewith declare that the above information is correct and complete and that transport will be made according to the
statuatory provisions.

Company Phone: ________________________________

_____________________________________________ Fax: ________________________________

_____________________________________________ E-mail address: ________________________________

Address:

_____________________________________________

_____________________________________________

Name:________________________________________ Position: ________________________________

_____________________________________________ _____________________________________________
Date Stamp/Signature

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