Clearance Certificate Form - Hirschmann pipetus standard Bedienungsanleitung

15. Clearance certificate form

for unit .............................
Blood, bodily fluids, patholog. samples:
Other hazardous biologic substances:
Biologically-degradable materials which can pose a risk:
Chemicals containing substances harmful to health:
Radioactive materials:
Other hazardous and toxic substances:
We hereby declare that
- the unit has been carefully cleaned and decontaminated prior to shipment
- no risks resulting from contamination exist
- we are aware that liability claims can be made against us in the event of damage being caused by contaminated units.
Address of sender:
..................... (Serial number)
Name:
Date:
Signature:
Medium used: ..............................................................
YES NO Please define in case of Yes
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