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10. Certifi cate of Decontamination
Disinfection and decontamination are required prior to shipping the instrument and accessories for repair.
Returned Instruments must be accompanied by a signed and dated Certifi cate of Decontamination, which
must be attached to the inside packaging of the instrument.
To disinfect and decontaminate: Wipe off the magnetic rod assembly, plunger bar, inside platform, and
inside and outside surfaces using a cloth dampened with 70% ethanol. Follow immediately with a cloth
dampened with deionized water. Repeat the procedure as many times as required to eff ectively disinfect and
decontaminate the instrument.
Failure to confi rm disinfection and decontamination will result in decontamination charges before the
instrument will be serviced.
Select either (A) or (B):
A. I confi rm that the returned items have not been contaminated by body fl uids or by toxic, carcino-
genic, radioactive, or other hazardous materials.
B. I confi rm that the returned items have been decontaminated and can be handled without exposing
personnel to health hazards.
Circle the type of material used in the instrument:
Briefl y describe the decontamination procedure performed:
Date:
Place:
Signature:
Name (block capital letters):
** The signature of a Radiation Safety Offi cer is also required if the instrument was used with radioac-
tive materials.
This instrument is certifi ed by the undersigned to be free of radioactive contamination.
Date:
Place:
Signature:
Name (block capital letters):
Promega Corpora on · 2800 Woods Hollow Road · Madison, WI 53711-5399 USA · Toll Free in USA 800-356-9526 · 608-274-4330 · Fax 608-277-2516
www.promega.com
Chemical Biological
Radioactive**
63
TM424 · Revised 2/15
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