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CAUTION
Please fill in this form before servicing.
Hand over this form to the service engineer to keep for his and your safety.
Safety check sheet
1. Freezer contents : 䂔Yes㩷㩷䂔No
Risk of infection: 䂔Yes㩷㩷䂔No
Risk of toxicity: 䂔Yes㩷㩷䂔No
Risk from radioactive sources: 䂔Yes㩷㩷䂔No
(List all potentially hazardous materials that have been stored in this unit.)
Notes :
2.
Contamination
of the unit:
Unit interior: 䂔Yes㩷㩷䂔No
No contamination: 䂔Yes㩷㩷䂔No
Decontaminated: 䂔Yes㩷㩷䂔No
Contaminated: 䂔Yes㩷㩷䂔No
Others:
3. Instructions for safe repair/maintenance of the unit
a) The unit is safe to work on 䂔Yes㩷㩷䂔No
b) There is some danger (see below) 䂔Yes㩷㩷䂔No
Procedure to be adhered to in order to reduce safety risk indicated in b) below.
Date :
Signature :
Address, Division :
Telephone :
Product name: Model: Serial number: Date of installation:
Ultra-low temperature MDF-594C
f
reezer
Please decontaminate the unit yourself before calling the service engineer.