Emerson Process Management 787, 788, 789C DANIELTM MEASUREMENT AND CONTROL, INC. , RETURNED MATERIAL AUTHORIZATION

DANIELTM MEASUREMENT AND CONTROL, INC.

RETURNED MATERIAL AUTHORIZATION

A Return Material Authorization (RMA) number must be obtained prior to returning any

equipment for any reason. Download the RMA form from the Support Services web page by

selecting the link below.

http://www2.emersonprocess.com/EN-US/BRANDS/D ANIEL/SUPPORT-SERVICES/Pages/

Support-Services.aspx

1. Return Material Authorization (RMA) Number

2. Equipment to be returned:

Model Number Serial Number

3. Reason for return:

Decontamination/Cleaning Fluids Process

A. List each substance in which the equipment was exposed. Attach additional documents if necessary.

Common

Name

CAS# if

Available

Used for Hazardous

Waste (20 CFR 261)

EPA Waste Code

if used for hazardous waste

[ ] Yes [ ] No

B. Circle any hazards and/or process fluid types that apply:

Infectious

Cyanides

Carcinogen

Radioactive

Sulfides

Peroxide

Explosive

Corrosive

Reactive-Air

Pryophoric

Oxidizer

Reactive-Water

Poison Gas

Flammable

Reactive-Other (list):

Poison

Other Hazard Category (list):

C. Describe decontamination/cleaning process. Include MSDS description for substances used in

decontamination and cleaning processes. Attach additional documents if necessary.