CAUTION
Please fill in this form before servicing.
Hand over this form to the service engineer to keep for his and your safety.
Safety check sheet
1. Refrigerator contents : | □Yes | □No | |
□Yes | □No | ||
Risk of infection: | |||
□Yes | □No | ||
Risk of toxicity: | |||
□Yes | □No | ||
Risk from radioactive sources: | |||
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(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:
□Yes □No □Yes □No □Yes □No □Yes □No
3. Instructions for safe repair/maintenance of the unit |
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a) The unit is safe to work on | □Yes | □No |
b) There is some danger (see below) | □Yes | □No |
Procedure to be adhered to in order to reduce safety risk indicated in b) below.
Date :
Signature :
Address, Division :
Telephone :
Product name: | Model: | Serial number: | Date of installation: |
MDF- |
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freezer |
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Please decontaminate the unit yourself before calling the service engineer.
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