Ny Formulärsida CONTACT INFORMATIONj Company * Filled in by * Address Phone E-mail * Contact at Fluid-Bag * Kass, Henrik Nylund, Solange Fredlund, Johan Björklund, Patrick Lampa, Christoffer Robinson, CLS, O.M.A., John Högkulla, Joel Sundqvist, Mats Precup, Michael Lindahl-Palmroos, Micaela Berglund, Magnus Sandelin, Lina-Maria Sandström, Charlotte Lygdman, Ida Stenman, Maria A. PRODUCT INFORMATION Inner Container (see Yellow Label on top valve) Type * Trace no * Serial no * Transport bag (see "QA Controlled" on transport bag label) Code no * Date * Signature * Transport Pallet MULTI (see Identification Plate on pallet) Type * Serial no * Transport Pallet FLEXI Type * Code no * Equipment (where applicable see Identification Plate) Type * Code no * B. PRODUCT FILLED IN FLUID-BAG Fluid-Bag is/was filled with the following product * C. DESCRIPTION OF THE CLAIM* (please attach photos) Description of the claim Attachments(max 1 MB/attachment) Attachment 1 Attachment 2 Attachment 3 Attachment 4 Attachment 5 Attachment 6 Attachment 7 Attachment 8 Attachment 9 Attachment 10 D. ESTIMATE OF DAMAGE Estimate of damages/costs (EUR) E. DEFECTIVE PRODUCT HAS BEEN/ WILL BE SENT TO FLUID-BAG Yes No Tweet