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Appendix A - Certificate of
Decontamination
The decontamination procedure is required prior
to shipping the instrument e.g., for repair. If, for
any reason, the instrument is shipped back to Oy
Growth Curves Ab Ltd, it must be accompanied by
a dated and signed Certificate of
Decontamination, which must be attached to the
outside of the package containing the instrument.
See Section 2.8 “Cleaning and Decontamination
of the Instrument”.
Failure to confirm decontamination will incur
additional labor charges or at worst the items will
be returned for proper cleaning.
Before returning any instrument(s) or item(s),
ensure that they are fully decontaminated.
Serial number of Bioscreen C° Pro:
________________________________________
Owner (company):
________________________________________
Contact person:
________________________________________
Phone:
________________________________________
E-mail:
________________________________________
□
I confirm that the returned items
have not been contaminated by
body fluids, toxic, carcinogenic or
radioactive materials or any other
hazardous materials.
□
I confirm that the returned items
have been decontaminated and
can be handled without exposing
the personnel to health hazards.
Materials used in the unit:
□
Chemicals
□
Biological
□
Radioactive *)
Specific information about contaminants:
________________________________________
________________________________________
________________________________________
Decontamination procedure and
decontamination solutions used:
________________________________________
________________________________________
________________________________________
Date and place:
________________________________________
Signature:
________________________________________
Clarification of signature:
________________________________________
*) The signature of a Radiation Safety Officer is
also required when the unit has been used with
radioactive materials.
This unit is certified by the undersigned to be free
of radioactive contamination.
Date and place:
________________________________________
Signature:
________________________________________
Clarification of signature:
________________________________________
