Certificate of Decontamination
In order to protect our employees, Tomtec must have a properly completed Certificate Of Decontamination for all items being returned. Any item that is not accompanied by a decontamination form will not be processed.

Model#& Serial# of Item:______________________________________________________RMA#__________

TYPE OF CONTAMINATION: (Please Check Off The Appropriate Box):

New, unused item:

  • No decontamination necessary, but you must still fill in this form and sign at the bottom.

Biological or Hazardous Chemicals :

  • Run a minimum of 5 liters of a disinfectant solution consisting of a 10% mix of 5.25% sodium hypochlorite (bleach) and 90% distilled water through any device that uses reagents EX...Harvesters, Plate Washers, ETC....
  • Rinse device with a minimum of 5 liters of distilled water to remove the disinfectant solution. Note, leaving the disinfectant solution in the device may cause damage.Rinse device with a minimum of 5 liters of distilled water to remove the disinfectant solution. Note, leaving the disinfectant solution in the device may cause damage.
  • Remove all external tubing lines (do not send tubing lines or Autotraps to Tomtec).
  • Wipe down exterior surfaces with the disinfectant solution. This applies to ALL devices, accessories,assemblies and non-electric parts being returned for any reason.
Radioactive :
  • Run a minimum of 10 liters of a decontamination solution appropriate for the type of contamination through any device that uses reagents. Ex...Harvesters, Plate Washers ETC...
  • Rinse device with a minimum of 5 liters of distilled water to remove the decontamination solution.
  • Remove all external tubing lines (do not send tubing lines or Autotraps to Tomtec).
  • Wipe down exterior surfaces with the decontamination solution and conduct a swipe test to ensure the device is safe to handle. Swab all accessible areas directly exposed to the flow of the contaminate as well as the exterior surfaces.
  • If the test results do not show the device is safe for handling, repeat the steps above. The results of a swipe test showing the device is safe for handling must be faxed to Tomtec along with the Return Materials Notice. A copy must also be included with the device. Be sure the areas swiped are identified and the background reading is clearly marked.

STATEMENT OF SAFETY:

 

I,__________________________certify that the item listed above has been examined by me for any possible hazardous materials and is safe for handling.

 

 

Signed:_________________________ Title:__________________ Date:___________________

 

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