OHAUS Frontier FC5513R Mode D'emploi page 39

Table 7: Redemption form / Decontamination certificate
Enclose this form with all returns of equipment and assemblies!
The completed declaration about the decontamination is a prerequisite for the assumption and further processing of the return. If no
corresponding explanation is enclosed, we carry out decontamination with costs at your expense.
.
Surname; last name:
Organization / company:
Street:
ZIP CODE:
Telephone:
E-Mail:
Pos. Crowd
1
2
3
4
Are the parts listed above in contact with the following substances?
Health endangering watery solutions, buffers, acids, alkalis:
Potentially infectious agents:
Organic reagents and solvent:
Radioactive substances:
Health endangering proteins:
DNA:
These substances have reached the equipment/assembly?
Which one, if yes:
Description of the measures for the decontamination of the listed parts:
I confirm the proper decontamination:
Company/Dept.
Signature of the authorized person n:
Place:
Fax:
Decontaminated Serial number
object
Place and Date:
Description / Comment
 Yes
 Yes
 Yes
α.. β.. γ
 Yes
 Yes
 Yes
 Yes
No
No
No
No
No
No
No