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1--­.� 6 0 <br />St Joseph's Medical Center Environmental Services Dept <br />North Corner Lot Sterilizer - Spordi Test <br />Date test performed—_761 I I Test performed by <br />Lot # Z,/yv <br />Expiration date zf711/ •r - <br />Staple SPORDI Test Envelope in space below after completing test: <br />(Make sure that flaps are securely closed so that test strips will not fall out) <br />Directions for Laboratory Specimen Processing Dept: <br />Do not order test in RUBICON System. Send this form with the SPORDI Envelope <br />attached directly to the Microbiology Dept at HCCL <br />Set up Date: 7/ ,z,0/1 I <br />Time: y'-' By:1 <br />Positive Control 4 - <br />Test strip 1�-- <br />Test strip 2 •— - - <br />i <br />Directions for Microbiology CLS: <br />When test is complete, fill out the Sterility Test Report section on the envelope. <br />Remember to sign and date the form, reattach a copy then send original test envelope to: <br />SJMC Environmental Services Dept. <br />Attention: Linda McAlister <br />Please contact Linda McAlister at X 6472 immediately if there is a test failure. <br />r <br />V <br />