Promega Corporation · 2800 Woods Hollow Road · Madison, WI 53711-5399 USA · Toll Free in USA 800-356-9526 · 608-274-4330 · Fax 608-277-2516
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www.promega.com
TM320 · Revised 4/15
12. Certificate of Decontamination
Disinfection and decontamination are required prior to shipping the instrument and accessories for repair.
Returned instruments must be accompanied by a signed and dated Certificate of Decontamination, which
must be attached to the outside packaging of the instrument.
To disinfect and decontaminate: Wipe o
ff
the magnetic rod assembly, plunger bar, inside platform, and
inside and outside surfaces using a cloth dampened with 70% ethanol, then a cloth dampened with a 1–2%
bleach solution in deionized water. Follow immediately with a cloth dampened with deionized water to
remove any residual bleach from the instrument surfaces. Repeat the procedure as many times as required
to e
ff
ectively disinfect and decontaminate the instrument.
Failure to confirm disinfection and decontamination will result in decontamination charges
before the instrument will be serviced.
Select either (A) or (B):
A.
I confirm that the returned items have not been in contact with body fluids or toxic, carcinogenic, radioac-
tive, or other hazardous materials.
B.
I confirm that the returned items have been decontaminated and can be handled without exposing personnel
to health hazards.
Circle the type of material used in the instrument:
Chemical
Biological
Radioactive**
Briefly describe the decontamination procedure performed:
Date:
Place:
Signature:
Name (block capital letters):
** The signature of a Radiation Safety Officer is also required if the instrument was used with radioactive materials.
This instrument is certified by the undersigned to be free of radioactive contamination.
Date:
Place:
Signature:
Name (block capital letters):
