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15. Clearance certificate form
®
for pipetus
...................
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 until 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:
pipetus_BA_(D)_(GB)_1005.indd 40
pipetus_BA_(D)_(GB)_1005.indd 40
All manuals and user guides at all-guides.com
- 40 -
..................... (Serial number)
Name:
_______________________________________________________
Date:
_______________________________________________________
Signature: _______________________________________________________
Medium used:
..................................................
Yes
No
Please define in case of YES
o
o
___________________________
o
o
___________________________
o
o
___________________________
o
o
___________________________
o
o
___________________________
o
o
___________________________
27.10.2005 9:30:01 Uhr
27.10.2005 9:30:01 Uhr
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