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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 : ƑYesƑNo
Risk of infection: ƑYesƑNo
Risk of toxicity: ƑYesƑNo
Risk from radioactive sources: ƑYesƑNo
(List all potentially hazardous materials that have been stored in this unit.)
Notes :
2.
Contamination of the unit:
Unit interior: ƑYesƑNo
No contamination: ƑYesƑNo
Decontaminated: ƑYesƑNo
Contaminated: ƑYesƑNo
Others:
3. Instructions for safe repair/maintenance of the unit
a) The unit is safe to work on ƑYesƑNo
b) There is some danger (see below) ƑYesƑNo
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-U500VX
freezer MDF-U500VXC
Please decontaminate the unit yourself before calling the service engineer.