GE akta start Maintenance Manual page 205

Product return or servicing
Retu rn authorizat ion
numb ber:
To ma ke sure the mu utual protectio
all equ uipment must be clean and f
your e quipment, ple ase complete
1. Please note e that items wi
2. Equipment which is not s
could be su bject to additi
Visible cont amination wil
3.
P Please specify
Yes No
Radioactivity (p R
In nfectious or ha
O Other Hazardo
Equip pment must be e decontamin
you fo or additional i information c
Telep phone No:
Liqui d and/or gas in equipment
Equip pment type / P Product No:
I here eby confirm th hat the equipm
area has been mad de safe and a
Nam e:
Posit tion or job title e:
Signe ed:
To rec eive a return authorization
please e call local tec chnical suppo
ÄKTA start Maintenance Manual 29-0603-08 AC
Healt
for Pr
and/or
S Service Ticket
on and safety of GE personn nel, our custom
free of any haz zardous conta aminants befo
this checklist and include it with your retu
ll NOT be acce epted for servi cing or return
ufficiently clea aned prior to r return to GE m
onal charges
l be assumed hazardous and d additional cl
y if the equipm ment has been n in contact wi
please specify)
azardous biolo ogical substan ces (please sp
ous Chemicals (please specify y)
nated prior to service / retu rn. Please pro
oncerning the e system / equ uipment.
Wate er
t is:
Ethan nol
None e, empty
Argo n, Helium, Nit
Liqui d Nitrogen
Other, p lease
specify
ment specifie d above has b been cleaned t
ccessible.
n number or s ervice numbe er,
rt or custome er service.
8.1 Health and Safety Declaration Form
th & Safe ety Dec
roduct R Return o
t/Request:
mers, transpor tation personn
re shipping to GE. To avoid d
urn.
without this fo orm
may lead to del ays in servicin
leaning and de econtaminatio
ith any of the following:
pecify)
ovide a teleph one number w
trogen
Seria l No:
to remove any y hazardous s
Comp pany or
instit tution:
Date (YYYY/MM/DD D)
GE and GE monogram are trade emarks of General E
GE Healthc are Bio-Sciences Co rp, 800 Centennial A
NJ 08855-1 1327, US
© 2010-14 General Electric Com mpany—All rights res
8 Reference information
laration n Form
or Servic cing
nel and our en nvironment,
delays in the p rocessing of
ng the equipm ent and
on charges wil l be applied
where GE can
contact
substances an nd that the
Electric Company.
Avenue, P.O. Box 132 7, Piscataway,
served. First publishe ed April 2010.
D DOC1149544/28-980 00-27 AC 05/2014
205