Hand over this form to the service engineer to keep for his and your safety.
1. Freezer contents :
Risk of infection:
Risk of toxicity:
Risk from radioactive sources:
(List all potentially hazardous materials that have been stored in this unit.)
Notes :
2. Contamination of the unit
Unit interior
No contamination
Decontaminated
Contaminated
Others:
3. Instructions for safe repair/maintenance/disposal of the unit
a) The unit is safe to work on
b) There is some danger (see below)
Procedure to be adhered to in order to reduce safety risk indicated in b) below.
Date :
Signature :
Address, Division :
Telephone :
Product name:
Ultra-low temperature
f
reezer
Please decontaminate the unit yourself before calling the service engineer.
58
CAUTION
Please fill in this form before servicing.
Safety check sheet
Model:
MDF-
□
□
Yes
No
□
□
Yes
No
□
□
Yes
No
□
□
Yes
No
□
□
Yes
No
□
□
Yes
No
□
Yes
□
Yes
Serial number:
□
No
□
No
Date of installation: