CyBi
®
-Well
Release:
09/2008
73
A 1
Declaration of Safeness
Hereby
I/we
certify
that
the
insides
and
outsides
of
the
device
described
below
(inclusive
of
all
supplementary
equipment
and
accessories)
have
been
cleaned
and
disinfected
and
are
free
of
any
infectious,
radioactive
or
otherwise
hazardous
or
toxic
substances,
and
that
no
risk
or
danger
is
involved
in
servicing
the
device.
Name/Description:
__________________________________
Serial number:
_________________
__________________________________
Place,
date
Signature,
name
and
company
Person
responsible
for
operating
the
above
device:
__________________________________
Artisan Technology Group - Quality Instrumentation ... Guaranteed | (888) 88-SOURCE | www.artisantg.com