3M Attest™ Auto-reader 490H Template

Type
Template
Sterilization Cycle Details
Chemical
Indicator
Biological Indicator
Test or
Control BI
Lot # Incubation Details
Fluorescent
Result
Date Load# Sterilizer#
Cycle
Type
Load Contents Circle One Circle One Lot # Well #
Time In
Date
Initials
Time out
Date
Initials
Circle One
Vaporized Hydrogen Peroxide Sterilization Record Keeping Sheet
Use with 3M™ Attest™ Rapid Readout Biological Indicator 1295
Facility/Dept. Name _______________________________________
Do NOT place another label or
indicator tape on the vial or on the cap.
Pass
Fail
Pass
Fail
Pass
Fail
Pass
Fail
Pass
Fail
Pass
Fail
Pass
Fail
Test
Control
Test
Control
Test
Control
Test
Control
Test
Control
Test
Control
Test
Control
+
+
+
+
+
+
+
©2017 3M. All rights reserved. May be reproduced by facilities using the 3M™ Attest™ Rapid Readout Biological Indicator 1295. 3M and Attest are trademarks of 3M.
70-9700-0047-0
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3M Attest™ Auto-reader 490H Template

Type
Template

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