Decontamination Certificate - palintest Macro 900 Operation Manual

Macro 900 Operation Manual V3

18.2. Decontamination Certificate

Please print this certificate, complete all sections, and enclose it with any
returned equipment.
Decontamination Certificate
Company Name: ____________________________________
Address:
_______________________________________________________________
________________
_______________________________________________________________
________________
_______________________________________________________________
________________
_______________________________________________________________
________________
Postal code: ___________________________________
Country: ______________________________________
Phone: ________________________________________ email:
__________________________________________
Product: ______________________________________ Serial No.:
______________________________________
Contaminant (if known):
___________________________________________________________________________
Decontamination Procedure:
_______________________________________________________________________
____________________________________________________________________________
___________________
Certified by (print name) : ___________________________________ Title:
__________________________________
Date: ______________________________________
Signature: __________________________________
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