OHAUS Frontier FC5706 Manual De Instrucciones página 27

TM
Frontier Centrifuge FC5706
12.6 Table 6: Redemption form / Decontamination certificate
Enclose this form with all returns of equipment and assemblies!
The complete declaration about the decontamination is a prerequisite for further processing of the return. If no corresponding explanation is
enclosed, we carry out decontamination at the expense of the customer.
Surname; last name: _________________________________________
Organization / company: _______________________________________
Street: _____________________________________________________
ZIP CODE: _____________ City:____________________
Telephone: _____________ Fax:____________________
E-Mail:_____________________________________
Pos. Crowd Decontaminated
object
1
2
3
4
Have the parts listed above been exposed to any of the following substances?
Health endangering watery solutions, buffers, acids, alkalis:...
Potentially infectious agents: ........................................................................  Yes No
Organic reagents and solvent: ......................................................................  Yes No
Radioactive substances: ........................................................ α.. β.. γ.. . Yes No
Health endangering proteins: ........................................................................  Yes No
DNA: .......................................................................................................  Yes No
These substances have reached the equipment/assembly? ................................  Yes No
Which one, if yes:
________________________________________________________________
Description of the measures for the decontamination of the listed parts:
I confirm the proper decontamination:
Company/Dept .____________ Place and Date: ____________________________________
Signature of the authorized person:________________________________________
Serial number Description / Comment
...............................  Yes No
EN-21