CDP301 Dew-Point Tester User’s Manual
50 97585 Issue 1, June 2020
APPENDIX D
Appendix D Analyzer Return Document & Decontamination Declaration
F0121, Issue 2, December 2011
Decontamination Certicate
IMPORTANT NOTE: Please complete this form prior to this instrument, or any components, leaving your
site and being returned to us, or, where applicable, prior to any work being carried out by a Michell
engineer at your site.
Instrument Serial Number
Warranty Repair? YES NO Original PO #
Company Name Contact Name
Address
Telephone # E-mail address
Reason for Return /Description of Fault:
Has this equipment been exposed (internally or externally) to any of the following?
Please circle (YES/NO) as applicable and provide details below
Biohazards YES NO
Biological agents YES NO
Hazardous chemicals YES NO
Radioactive substances YES NO
Other hazards YES NO
Please provide details of any hazardous materials used with this equipment as indicated above (use continuation sheet
if necessary)
Your method of cleaning/decontamination
Has the equipment been cleaned and decontaminated? YES NOT NECESSARY
Michell Instruments will not accept instruments that have been exposed to toxins, radio-activity or bio-hazardous
materials. For most applications involving solvents, acidic, basic, ammable or toxic gases a simple purge with dry
gas (dew point <-30°C) over 24 hours should be sufcient to decontaminate the unit prior to return.
Work will not be carried out on any unit that does not have a completed decontamination declaration.
Decontamination Declaration
I declare that the information above is true and complete to the best of my knowledge, and it is safe for Michell
personnel to service or repair the returned instrument.
Name (Print) Position
Signature Date
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