Thermo Scientific 61-12C, Руководство по эксплуатации и обслуживанию

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Service, Repair, and Replacement Parts
Parts Ordering Information
Thermo Fisher Scientific REC 3449 Rev M 5-5
501 90 th Avenue N.W. 1-800-445-3503
Minneapolis, MN 55433 Fax: 763.783.2525
11/27/2008 www.thermo.com
DECONTAMINATION FORM
Please complete all areas of the Decontamination Declaration below.
• Orders without a Decontamination Declaration will not be processed and the
instrument will be returned to the sender via collect freight.
• Please send this form with a hard copy of your PO to the above email or fax number to
obtain an RMA number for shipping. Retain a copy for your records.
Please provide a specific description of your system’s use:
Describe type of product run on your equipment:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Please describe all cleaning and/or decontamination performed:
____________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
___________________________________________________________________________________
Check all that apply:
Out of Box Failure Non-Hazardous Materials only Hazardous Material (See Below)
Hazardous Materials:
Carcinogen Bacteria Fungus Pathogen Toxic Substance
Radioactive Virus Corrosive
Chem. Hazard
Flammable Chem.
Hazard
Reactive Chem.
Hazard
Animal/ Plant/ Mineral (Explain)
__________________________________________
__________________________________________
___________________
Other (Explain)
__________________________________________
__________________________________________
___________________
To the best of my knowledge, this equipment is free of harmful or hazardous chemical, biological or radioactive
contamination. I understand that if the equipment is found to be contaminated, regardless of the signature on
this document, the equipment will b e returned at my company's expense.
Signature: ____________________Title: ____________Date: ______