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BACTERIOLOGY � SUPERVISOR <br />�3mLABORATORY <br />STERILIZATION TEST DATA <br />To (Supervisor) <br />Institution " <br />DepartmentDate <br />i <br />of test <br />Date/Time strips were culture <br />Sterilant <br />Steam . <br />Temperature at which strips were incubated: <br />EO El�) <br />30°C to 35°C ❑ 55°C to 60`C <br />Dry Heat ❑ <br />Results of culture tests (check one)/ <br />QQ <br />Location of sterilizer J `� ,_Id <br />Both strips NEGATIVE fid' POSITIVE ❑ <br />Type of Load <br />One strip NEGATIVE the other POSITIVE ❑ <br />Sterilizing conditions: <br />Control strip results: NEGATIVE ❑ POSITIVE <br />Recommended Actions: <br />Time of Strip Retrieval-- <br />_ <br />Test conducted by <br />Signature- �ll�/ ate <br />Department s �}� <br />