Leica Biosystems CM1100 - Manual (Page 34)

34 Instructions for use V1.3 RevB – 09/2012
14. Decontamination Certificate
(master)
Important - to avoid refusal of shipment:
Place one copy in the unit prior to packaging or hand it over to the service engineer. Customer assumes all responsibility for
the immediate return shipment of articles sent to Leica without proper decontamination documentation.
If you have any further question, please call your local Leica organisation.
Description
Name/Model Fabr. No.
KAT No. Quantity
A
This equipment has not been in contact with unfixed biological samples.
B This equipment has been exposed internally or externally to hazardous materials as
indicated below:
1
3 The equipment has been prepared to ensure safe handling/transportation.
Whenever possible, please use the original transportation case/box.
Please provide further detail here:
Blood, body fluids, pathological samples
Other biohazards
Chemicals/substances hazardous to health
Other hazards
2 This equipment has been cleaned and decontaminated:
Please provide further detail here:
If yes, give details of the method:
If no*, please indicate why not:
* Such equipment must not be returned without the written agreement of Leica Biosystems.
Tick Box A if applicable. Otherwise please complete all parts of B, providing furt-
her information as requested or appropriate.
Yes No
Yes No
Yes No
Leica Internal Use: If applicable, note corresponding Job and RAN-/RGA-Number:
Job Sheet No.:
____________________
SU Return Goods Authorisation: ____________________ BU Return Authorisation Number: ___________________
Signature/Date
Name
Institute
Department
Adress
Position
eMail Phone Facsimile
Leica Biosystems Nussloch GmbH
Heidelberger Str. 17-19
69226 Nussloch, Germany
Phone: ++49 (0) 6224 143 0
Fax:
++49 (0) 6224 143 268
www.LeicaBiosystems.com
Yes
Dear Customer, any product that is to be returned to Leica Microsystems or serviced on site, must be cleaned and decon-
taminated in the appropriate manner. Since it is not possible to decontaminate for prion diseases, such as CJD, BSE, CWD
etc., equipment exposed to specimens containing prion diseases cannot be returned to Leica Microsystems for repair. On-
site repair of prion contaminated equipment will only be conducted after the Field Service Engineer has been educated in
the risks, instructed in the policies and procedures of the institution and provided with personal protective equipment. This
certificate, duly completed, must be placed in the instrument, attached to the outside of the shipping crate or handed directly
to the service engineer. Packages will not be opend 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.