Declaration of Decontamination by the Operator
Concerning the contamination of centrifuges, accessories, and spare parts.
This declaration may only be filled out and signed by authorized staff.
Repair order no. Date
Type of unit Serial no. Year
Type of unit Serial no. Year
Type of unit Serial no. Year
Type of unit Serial no. Year
Accessories
Are the components free from harmful substances? YES NO
If not, which substances has the equipment come into contact with?
Names of the
substances
Remarks:
(e.g. to handle with gloves
only)
General characteristics of the substances
Caustic
Toxic Corrosive
Explosive
Biologically hazardous Radioactive
In Combination with which substances can hazardous mixtures develop?
Names of the
substances
Have the components been cleaned before shipment! YES NO
Is the equipment decontaminated and
not harmful to human health? YES
NO
Prior to repair, radioactive contaminated components must be decontaminated according to the valid
regulations for radiation protection!
Legally Binding Declaration
I / we hereby declare that the information on this declaration is correct and complete.
Company/Institute
Street
Postcode, City
Phone Fax
Name
Date
Signature Stamp
Please make some copies before removing this page!
Fi
. 11.3: Declaration of Decontamination
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