44
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. Unit contents:
Risk of infection:
□
Yes
□
No
Risk of toxicity:
□
Yes
□
No
Risk from radioactive sources:
□
Yes
□
No
(List all potentially hazardous materials that have been stored in this unit.)
Notes:
2.
Contamination of the unit:
Unit interior:
No contamination:
□
Yes
□
No
Decontaminated:
□
Yes
□
No
Contaminated:
□
Yes
□
No
Others:
3. Instructions for safe repair/maintenance/disposal of the unit
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:
Pharmaceutical
Refrigerator
Model:
MPR-
Serial number:
Date of Installation:
Please decontaminate the unit yourself before calling the service engineer.
