QA028/ISSUE3/JAN98(F003) HEALTH AND SAFETY AT WORK ACT
DECONTAMINATION CERTIFICATE 

Any product which is to be returned to Bright Instrument Co Ltd
or serviced on site, must be cleaned and decontaminated in the
appropriate manner. This certificate, duly completed, must be
either sent in advance (fixed to the outer packing containing
the product), or handed to the service engineer.

Packages will not be opened 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. 



Description: .................................................................

             ......................................

Product Code: ..........................  Serial Number: ............................

Order Number: ..........................    Quantity: ...............................


Tick Box A if applicable. Otherwise complete all parts of B,
providing further information as requested or appropriate. 

A. 	[   ]  	This equipment has not been in contact with unfixed biological 	
                  samples. 

B	1.	This equipment has been exposed internally or externally to hazardous 

(delete as	      materials as indicated below: 
appropriate)	YES/NO 	Blood, body fluids, pathological samples 
		      YES/NO 	Other biohazards 
       		YES/NO 	Chemicals/substances hazardous to health 
      		YES/NO 	Other hazards  	

	      	Provide further details here:.............................................

      	...............................................................

            ...........................................


	2.	YES/NO This equipment has been cleaned and decontaminated:

		If YES, give details of the methods: ............................................

		.................................................................................

            .......................


		If NO*, please indicate why not: ................................................

		.................................................................................

	 * Such equipment must not be returned without the written agreement of Bright Instrument
        Company Limited.	

      	Provide further details here: ....................................................

		..................................................................................

	3.	YES/NO The equipment has been prepared to ensure safe handling/transportation.

Signature: ..............................................................

Name: ................................................................... (Block Capitals)

Position: ..........................................................................

Date: ...........................................................................

Institute: ...........................................................................

Department: ..........................................................................

Address: ............................................................................

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	Postcode: .............................................................

	Telephone: ................................................. Extn: ..........

	Facsimile: ...............................................................