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 : Risk of infection:
Risk of toxicity:
Risk from radioactive sources:
•Yes | • No |
•Yes | • No |
•Yes | • No |
•Yes | • No |
(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 |
|
|
a) The unit is safe to work on | DYes | DNo |
b) There is some danger (see below) | DYes | DNo |
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 : |
Sterilizer |
|
|
Please decontaminate the unit yourself before calling the service engineer.
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