ࡱ> ,.+ ^ bjbj 5bb Snnnnn8 Et,knnnXnnHppԐiS#`0Ehpnp8E 4:   EQUIPMENT RELEASE FORM Date:_______________________ Location:_____________________ Lab Supervisor:________________________ Department:___________________ Equipment Description Type or Use:______________________ Manufacturer:______________________ Model:___________________ S/N:_________________ WSU No:_____________ Purpose of Release ( ) Release for disposal ( ) Release for repair ( ) Release to ESPM for resale ( ) Release for general use ( ) Other______________________________________ Inspection results: No indication of chemical or biological contamination was found. Please call the department of Environmental Health & Safety (ext. 2215) if you have any questions. Notice to Lab Supervisor: If this equipment came into contact with radioactive agents, it is your responsibility to ensure that the equipment is properly cleaned before it is removed. Please call the Radiation Safety Officer (ext. 2169) if you need assistance. Also, if the equipment contains any type of freon, please call Physical Plant to have the freon removed. Comments:____________________________________________________________ _____________________________ ________________ Environmental Health & Safety Representative Date      FILENAME \p K:\EHS\Administrative\Forms\EquipmentReleaseForm.doc ^ q r * =        $ % Y Z [ \ ] ^ ʻhBPhWhWCJaJmHnHuhWhWCJaJjhWhWCJUaJhjhUh05OJQJ\^Jh0OJQJ^Jh05CJ OJQJ\^Jh0hij  ] ^ q r ( ) * V W  $a$       [ \ ] ^   &d P 3 0&P1/ =!"#$% 2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~8XV~_HmH nH sH tH <`< NormalCJ_HmH sH tH N@N  Heading 1$ @&5OJQJ\^JDA D Default Paragraph FontViV  Table Normal :V 44 la (k (No List B>@B Title$a$5CJ OJQJ\^J44 WHeader  !4 @4 WFooter  !PK!pO[Content_Types].xmlj0Eжr(΢]yl#!MB;.n̨̽\A1&ҫ QWKvUbOX#&1`RT9<l#$>r `С-;c=1g'}ʅ$I1Ê9cY<;*v7'aE\h>=,*8;*4?±ԉoAߤ>82*<")QHxK |]Zz)ӁMSm@\&>!7;ɱʋ3װ1OC5VD Xa?p S4[NS28;Y[꫙,T1|n;+/ʕj\\,E:! t4.T̡ e1 }; [z^pl@ok0e g@GGHPXNT,مde|*YdT\Y䀰+(T7$ow2缂#G֛ʥ?q NK-/M,WgxFV/FQⷶO&ecx\QLW@H!+{[|{!KAi `cm2iU|Y+ ި [[vxrNE3pmR =Y04,!&0+WC܃@oOS2'Sٮ05$ɤ]pm3Ft GɄ-!y"ӉV . `עv,O.%вKasSƭvMz`3{9+e@eՔLy7W_XtlPK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-!pO[Content_Types].xmlPK-!֧6 -_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!!Z!theme/theme/theme1.xmlPK-! ѐ'( theme/theme/_rels/themeManager.xml.relsPK]# ^ RU^  ^  OU8@0( U`& B S  ?      \_xzrv_a   \_:::::::: P ^`OJQJo( 8^8`OJQJo(^`OJQJ^Jo(o  p^ `OJQJo(  @ ^ `OJQJo( x^x`OJQJo(H^H`OJQJ^Jo(o ^`OJQJo( ^`OJQJo(pwCE|Z- 0WBP  @0yy^@UnknownG*Ax Times New Roman5Symbol3 *Cx Arial? *Cx Courier New;WingdingsA$BCambria Math"1h2ǐ2ydF6,R6,R!243HP?CE|2!xx EQUIPMENT RELEASE FORMWright State UniversityMarjorie Markopoulos  Oh+'0 $0 T ` l x'EQUIPMENT RELEASE FORMԭ Normal.dotmMarjorie Markopoulos2Microsoft Macintosh Word@@-D@xeuiS@xeuiS6 ՜.+,0 hp  'ԭR, EQUIPMENT RELEASE FORM Title  !"$%&'()*-Root Entry FrXԐiS/1Table 'WordDocument5SummaryInformation(DocumentSummaryInformation8#CompObj` F Microsoft Word 97-2004 DocumentNB6WWord.Document.8