APPENDIX C – CUSTOMER SERVICE
FS10 Series
72
Fluid Components International LLC
FCI Document No. 05CS000004D [U]
The following Return Authorization Request form and Decontamination Statement
MUST be completed, signed and faxed back to FCI
before
a Return Authorization Number will be issued. The signed Decontamination Statement and applicable MSDS Sheets
must be in-
cluded with the shipment
. FCI will either fax, email or telephone you with the Return Authorization Number upon receipt of the signed
forms.
Packing Procedures
1.
Electronics
should be wrapped in an
anti-static
or
static-resistant
bag, then wrapped in protective bubble wrap and surrounded
with appropriate dunnage* in a box. Instruments weighing
more than 50 lbs., or extending more than four feet
, should be se-
cured in wooden crates by bolting the assemblies in place.
2.
The sensor head must be protected
with pvc tubing, or retracted the full length of the probe, locked and secured into the Pack-
ing Gland Assembly (cap screws tightened down).
3. FCI can supply crates for a nominal fee.
4. No more than
four (4)
small units packaged in each carton.
5.
FCI will not be held liable for damage caused during shipping.
6. To ensure immediate processing
mark
the RA number on the outside of the box. Items without an RA number marked on the box
or crate may be delayed.
7. Freight
must be “PrePaid”
to FCI receiving door.
* Approriate dunnage as defi ned by UPS, will protect package contents from a drop of 3 feet.
Visit FCI on the Worldwide Web: www.fluidcomponents.com
1755 La Costa Meadows Drive, San Marcos, California 92078-5115 USA ‡ Phone: 760-744-6950 ‡ 800-854-1993 ‡ Fax: 760-736-6250
*** Decontamination Statement *** This Section Must Be Completed ***
Exposure to hazardous materials is regulated by Federal, State, County and City laws and regulations. These laws provide FCI’s
employees with the “Right to Know” the hazardous or toxic materials or substances in which they may come in contact while han-
dling returned products. Consequently, FCI’s employees must have access to data regarding the hazardous or toxic materials or
substances the equipment has been exposed to while in a customer’s possession. Prior to returning the instrument for evaluation/
repair, FCI requires thorough compliance with these instructions. The signer of the Certifi cate must be either a knowledgeable Engi-
neer, Safety Manager, Industrial Hygenist or of similar knowledge or training and responsible for the safe handling of the material to
which the unit has been exposed.
Returns without a legitimate Certifi cation of Decontamination, and/or MSDS when required, are
unacceptable and shall be returned at the customer’s expense and risk.
Properly executed Certifi cations of Decontamination must
be provided before a repair authorization (RA) number will be issued.
Certifi cation Of Decontamination
I certify that the returned item(s) has(have) been thoroughly and completely cleaned. If the returned item(s) has(have) been ex-
posed to hazardous or toxic materials or substances, even though it (they) has (have) been thoroughly cleaned and decontaminated,
the undersigned attests that the attached Material Data Safety Sheet(s) (MSDS) covers said materials or substances completely.
Furthermore, I understand that this Certifi cate, and providing the MSDS, shall not waive our responsibility to provide a neutralized,
decontaminated, and clean product for evaluation/repair at FCI. Cleanliness of a returned item or acceptability of the MSDS shall
be at the sole discretion of FCI.
Any item returned which does not comply with this certifi cation shall be returned to your location
Freight Collect and at your risk.
This certifi cation must be signed by knowledgeable personnel responsible for maintaining or managing the safety program at
your facility.
Process Flow Media _____________________________________________________________________________________
Product was or may have been exposed to the following substances: _______________________________________________
Print Name_____________________________________________________________________________________________
Authorized Signature ___________________________________________ Date _____________________________________
Company Title __________________________________________________________________________________________
