MET087_LOGSHEET_OPA_METRICIDE_P2_Layout 1 7/16/13 9:01 AM Page 1

Solution Testing Log Sheet for: (select only one)

MetriCide OPA™ Plus MetriCide ® ®

MetriCide 28 ®
MetriCide Plus 30 ®

WARNING: USE TEST STRIPS WITHIN 90 DAYS OF OPENING BOTTLE.

Date Test Strip Bottle First Opened _____________________ Do Not Use After (Date)____________________ Bottle Lot # __________
QC Test Results _____________________ QC Test Date _________________________ Tested By (initials) ______________________

WARNING: DO NOT USE SOLUTION BEYOND ITS STATED USE AND REUSE LIFE.
Date Solution Date Solution Date Time Temp. Solution MRC Instrument Model Patient ID # Tested By
Opened/ Expires Solution Tested Solution Tested in °F Test Results and Serial # (initials)
Activated Before Use (circle one)

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p.m. PASS FAIL
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p.m. PASS FAIL
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p.m. PASS FAIL
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p.m. PASS FAIL
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p.m. PASS FAIL
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p.m. PASS FAIL
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p.m. PASS FAIL
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p.m. PASS FAIL
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p.m. PASS FAIL
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p.m. PASS FAIL
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p.m. PASS FAIL
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p.m. PASS FAIL
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p.m. PASS FAIL
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p.m. PASS FAIL
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p.m. PASS FAIL
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p.m. PASS FAIL
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p.m. PASS FAIL

Location/Department:

______________________________________________________________________________
PROTECTING PEOPLE
For questions or comments, contact your Metrex representative at 1.800.841.1428
77-1402-2
or visit www.metrex.com