Safety Warning Notice
This is to be signed by the customer in the event that their machine fails a PSSR examination.
Sales - Castell Howell Foods
08/09/2022
Safety Warning Notice
This is to be signed by the customer in the event that their machine fails a PSSR examination.
Customer name
Customer address
Appliance details
Appliance make/model
Appliance serial number
Installation date if known
INFORMATION CONTAINED IN THE BOXES BELOW IS RELEVANT TO YOUR SAFETY
Has the appliance failed PSSR examination?
Classification
Reason:
FOR YOUR OWN SAFETY AND SAFETY OF OTHERS APPLIANCES CLASSIFIED AS AT RISK OR IMMEDIATELY DANGEROUS SHOULD NOT BE USED AND TAKEN OUT OF SERVICE UNTIL THE FAULT IS RECTIFIED AND PASSED A FOLLOW UP PSSR EXAMINATION
Have you advised the customer that the appliance needs to be removed from service?
Have you attached a warning label to the appliance?
Declaration: I have received this Safety Warning Notice. I understand having been advised, that to use an appliance categorised as IMMEDIATELY DANGEROUS or AT RISK presents a safety hazard which would place me in breach of current Pressure Systems Safety Regulations (PSSR 2000)
Please print name
Please sign
Click here to sign
Date of issue
Safety warning issued by:
Signed by engineer
Click here to sign
Date of issue
Source: Sales - Castell Howell Foods (Community Member)