OHAUS Frontier FC5714 Manual De Instrucciones página 54

Frontier TM Centrifuge FC5714/FC5718/FC5718R/FC5816/FC5816R/FC5916/FC5916R
11.7 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:.............................  Yes  No
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
object
Description /
Comment
EN-47