Chapter A; Certificate Of Decontamination - Thermo Scientific KingFisher Presto User Manual

Appendix A

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 *)
Special information about contaminants:
_________________________________________________________________________
_________________________________________________________________________
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: ___________________________________________________________
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Please include decontamination solution used.
Thermo Fisher Scientific
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Thermo Scientific KingFisher Presto User Manual
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