A SERVICE OF

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~.CAUTION
Please
fill
in
this
form
before servicing.
Provide
this
form
to
the service
engineer
to
keep
for
safety.
1.
Freezer
contents:
Risk of infection:
Risk of toxicity:
Safety check sheet
DYes
DYes
DNo
DNa
Risk from radioactive sources:
DYes
DNo
(List all potentially hazardous materials that have been stored in this unit.)
Notes:
2.
Contamination
of
the
unit
Unit interior
No contamination
Decontaminated
Contaminated
Others:
DYes
DYes
DYes
3. Instructions for safe repair/maintenance
of
the unit
DNo
DNo
DNo
a)
The unit
is
safe to work
on
DYes
DNo
b) There is some danger (see below)
DYes
DNa
Procedure to be adhered to
in
order to reduce safety risk indicated in b) above:
Date:
Signature:
Address, Division:
Telephone:
Product
name:
Model:
Serial number:
Date
of instal/ation:
Biomedical Refrigerator
SR-L6111
Please decontaminate the unit yourself before calling the service engineer.
20
English