R
/ F
T
EFRIGERATOR
REEZER
EMPERATURE
L
:_____________________
T
C
D
_______________
OCATION
HERMOMETER
ALIBRATION
UE
Serial number of Refrigerator/Freezer #________________
Thermometer Serial #_____________________
M
/ Y
:_________________
M
R
P
N
R
F
L
/S
ONTH
EAR
EDICATION
EFRIGERATOR
ATIENT
OURISHMENT
EFRIGERATOR
REEZER
AB
PECIMEN
Temperature Checks and Initials
Temperature Checks and Initials
Refrigerator
Freezer
Refrigerator
Freezer
Date
Temperature
Temperature
Signature
Date
Temperature
Temperature
Signature
Min/Max
Min/Max
Min/Max
Min/Max
1
16
2
17
3
18
4
19
5
20
6
21
7
22
8
23
9
24
10
25
11
26
12
27
13
28
14
29
15
30
31
Refrigerator should maintain temperatures between 36°F and 46°F (2°C and 8°C)
Freezer should maintain temperatures between 4°F and 14°F (-20°C and 26°C) unless otherwise specified by medication insert