Appendix B Certificate Of Decontamination - Thermo Scientific Wellwash Versa User Manual

Appendix B
Certificate of Decontamination
Name:
Address:
Tel./Fax:
Instrument: Serial No.:
A) I confirm that the returned items have not been contaminated by body fluids, toxic,
carcinogenic or radioactive materials or any other hazardous materials.
B) I confirm that the returned items have been decontaminated and can be handled without
exposing the personnel to health hazards.
Materials used in the unit: Chemicals + Biological • Radioactive *)
Specific information on contaminants:
1
Decontamination procedure :
Date and place:
Signature:
Name (block capitals):
*) The signature of a Radiation Safety Officer is also required when the unit has been used with
radioactive materials.
This unit is certified by the undersigned to be free of radioactive contamination.
Date and place:
Signature:
Name (block capitals):
1
Please include decontaminating solution used.
Thermo Fisher Scientific Thermo Scientific Wellwash Versa User Manual 141