OHAUS Frontier FC5917RF Manuel D'instructions page 67

EN-58
10.8 Table 8: 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: _______ __ place ________________
Telephone: ___ __ fax:_
E-Mail: _____________________________________
Pos. Crowd Decontaminated
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: ....................................................
β.. γ...
Yes No 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:________________________________________
_ _ _ _
_ _ _
_ _ _
Serial number
object
_ ____ _ Place and Date: _ ________________________________
_ _
_ _
Description /
Comment
Yes No
Yes No
Yes No
α..
Yes No
Yes No
Yes No
TM
Frontier Centrifuges