Apogee 21054010 Gebrauchsanweisung - Seite 13

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7.0 DECONTAMINATION DECLARATION

RGA Number (IMPORTANT): ___________________________________________________________

Customer Name: ____________________________________________________________________

Institute: ___________________________________________________________________________

Address: ___________________________________________________________________________

TEL #: ____________________________________ FAX #: __________________________________

E-mail: ____________________________________________________________________________

Unit type: _________________________________ Serial number: ___________________________

DESCRIPTION OF PROCEDURES USED TO DECONTAMINATE UNIT (LOOK AT 5.4.1)

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1. Gently washed with water and a non-abrasive detergent, and rinsed with deionized water.

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2. Using a solution of 5% household bleach in water or 70% ethanol in water, the unit was wiped

down using a clean cloth or sponge and neutralized with deionized water.

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3. To meet various regulatory and safety standards, please follow the decontamination procedures

given in 5.4.1 if radioactive materials were used with this product.

This piece of equipment has not been decontaminated. Reason:

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To the best of my knowledge, unit is free of chemical, biological, or radioactive contamination.

I understand that if the equipment is found to be contaminated, regardless of the signature on this

document, the equipment may be decontaminated at my expense. Also, if the equipment is found to be

contaminated, the response time for repairs will be delayed.

Signature: __________________________________________________________________________

Title: ________________________________________

Date: ________________________________________

Please place completed and signed form inside the box with the equipment where it can

immediately be noticed by the receiver. We appreciate you taking the time to perform

the necessary precautions to ensure that equipment being returned can be safely

handled by our employees.

Apogee Electrophoresis | 101 Kane Street | Baltimore, MD 21224 USA | apogeephoresis.com