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Rückgabe oder Wartung von
Produkten
Zur Aufzeichnung von Details zur Dekontamination vor einer Produktrückgabe oder -in-
standsetzung muss ein Bericht zum Health & Safety Declaration Form for Product Return
or Servicing, wie etwa im folgenden Beispiel, verwendet werden.
Amersham WB system Bedienungsanleitung 29-0214-77 AE
Retu
rn authorizat
ion
numb
ber:
To ma
ke sure the mu
utual protectio
on and safety
all equ
uipment must
be clean and f
free of any haz
your e
quipment, ple
ase complete
this checklist
1.
Please note
e that items wi
ll NOT be acce
2.
Equipment
which is not s
ufficiently clea
could be su
bject to additi
onal charges
Visible cont
amination wil
l be assumed
3.
P
Please specify
y if the equipm
Yes
No
R
Radioactivity (p
please specify)
In
nfectious or ha
azardous biolo
O
Other Hazardo
ous Chemicals
Equip
pment must be
e decontamin
nated prior to
you fo
or additional i
information c
oncerning the
Telep
phone No:
Liqui
d and/or gas
in equipment
t is:
Equip
pment type / P
Product No:
I here
eby confirm th
hat the equipm
ment specifie
area
has been mad
de safe and a
ccessible.
Nam
e:
Posit
tion or job title
e:
Signe
ed:
To rec
eive a return
authorization
n number or s
please
e call local tec
chnical suppo
rt or custome
7.3 Gesundheits- und Sicherheitserklärungsformular
Healt
th & Safe
for Pr
roduct R
and/or
S
Service Ticket
of GE personn
nel, our custom
mers, transpor
zardous conta
aminants befo
and include it
with your retu
urn.
epted for servi
cing or return
aned prior to r
return to GE m
may lead to del
hazardous and
d additional cl
ment has been
n in contact wi
ogical substan
ces (please sp
(please specify
y)
service / retu
rn. Please pro
ovide a teleph
e system / equ
uipment.
Wate
er
Ethan
nol
None
e, empty
Argo
n, Helium, Nit
Liqui
d Nitrogen
Other, p
lease
specify
Seria
d above has b
been cleaned t
Comp
instit
tution:
Date
GE and GE
ervice numbe
er,
GE Healthc
er
service.
NJ 08855-1
© 2010-14
7 Informationen zu Verweisen
ety Dec
laration
Return o
or Servic
t/Request:
tation personn
nel and our en
re shipping to
GE. To avoid d
delays in the p
without this fo
orm
ays in servicin
ng the equipm
leaning and de
econtaminatio
on charges wil
ith any of the
following:
pecify)
one number w
where GE can
trogen
l No:
to remove any
y hazardous s
substances an
pany or
(YYYY/MM/DD
D)
monogram are trade
emarks of General E
Electric Company.
are Bio-Sciences Co
rp, 800 Centennial A
Avenue, P.O. Box 132
1327, US
General Electric Com
mpany—All rights res
served. First publishe
DOC1149544/28-980
D
n Form
cing
nvironment,
rocessing of
ent and
l be applied
contact
nd that the
7, Piscataway,
ed April 2010.
00-27 AC 05/2014
229
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