A SERVICE OF

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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 : Yes No
Risk of infection: Yes No
Risk of toxicity: Yes No
Risk from radioactive sources: Yes No
(List all potentially hazardous materials that have been stored in this unit.)
Notes :
2.
Contamination
of the unit:
Unit interior: Yes No
No contamination: Yes No
Decontaminated: Yes No
Contaminated: Yes No
Others:
3. Instructions for safe repair/maintenance of the unit
a) The unit is safe to work on Yes No
b) There is some danger (see below) Yes 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-C8V
f
reezer
Please decontaminate the unit yourself before calling the service engineer.