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12.6 Table 6: Redemption form / Decontamination certificate
Enclose this form with all returns of equipment and assemblies!
The complete declaration about the decontamination is a prerequisite for further processing of the return. If no corresponding explanation is
enclosed, we carry out decontamination at the expense of the customer.
.
Surname; last name:
Organization / company:
Street:
ZIP CODE:
Telephone:
E-Mail:
Pos.
Crowd
1
2
3
4
Have the parts listed above been exposed to any of the following substances?
Health endangering watery solutions, buffers, acids, alkalis:
Potentially infectious agents:
Organic reagents and solvent:
Radioactive substances:
Health endangering proteins:
DNA:
These substances have reached the equipment/assembly?
Which one, if yes:
Description of the measures for the decontamination of the listed parts:
I confirm the proper decontamination:
Company/Dept.
Signature of the authorized person n:
City:
Fax:
Decontaminated
Serial number
object
Place and Date:
Frontier
Description / Comment
Yes No
Yes No
Yes No
α.. β.. γ
Yes No
Yes No
Yes No
Yes No
TM
Centrifuge FC5706
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