Revised May 2012
24
QA028/ISSUE5/OCT00(F003)
HEALTH AND SAFETY AT WORK ACT
DECONTAMINATION CERTIFICATE
Any product which is to be returned to Bright Instrument Company Limited or serviced on site, must be cleaned and
decontaminated in the appropriate manner. This certificate, duly completed, must be either sent in advance (fixed to the
outer packing containing the product), or handed to the service engineer.
Packages will not be opened nor servicing commenced until the Company or service engineer have received a
satisfactory certificate. Should returned goods be considered a hazard by the Company, they will be returned
immediately to the customer at his/her expense. NB: Microtome knives must be in boxes.
Description:
Product Code: Serial Number:
Order Number: Quantity:
Tick Box A if applicable. Otherwise complete all parts of B, providing further information as requested or appropriate.
A
This equipment has not been in contact with unfixed biological samples.
B1. This equipment has been exposed internally or externally to hazardous materials as indicated below:
YES/NO Blood, body fluids, pathological samples Provide further details here:
YES/NO Other biohazards
YES/NO Chemicals/substances hazardous to health
YES/NO Other hazards
2. This equipment has been cleaned and decontaminated:
YES/NO If YES, give details of the methods:
Provide further details here:
If NO*, please indicate why not:
* Such equipment must not be returned without the written agreement of Bright Instrument Company Limited.
3. The equipment has been prepared to ensure safe handling/transportation.
YES/NO
Signed: Institute:
Department:
Address:
Name: Postcode:
Position: Telephone: Extn:
Date: Facsimile:
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