Contamination Questionnaire - Sarstedt Automatic-Sarpette Bedienungsanleitung

Instruction Manual - Automatic-Sarpette
Dear customer,
For security reasons we ask you to answer all of the following questions before you send
your device in for maintenance, repair or return to the DESAGA GMBH / SARSTEDT GROUP
Wiesloch.
Company:
City:
Name:
Device/item:
❑ The device is free from harmful substances
❑ The device came into contact with the following harmful substances:
Substance class
❑ Toxic substances
❑ Corrosive substances
❑ Explosive materials
❑ Radioactive materials
❑ Infectious substances
❑ Oxidising substances
❑
❑ The device has been decontaminated in accordance with the statutory requirements
(Tick all that apply)
Description of the decontamination carried out.
Date:
Contamination questionnaire for repair orders
®
Department:
Street:
Phone:
Serial number:
Substance name
Signature:
15