Sirona Orthophos 3 Maintenance Manual page 28

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Customer: _________________________ Address: ________________________
Dealer: ____________________________ Address: ________________________
Date of original installation: ____________ Date of inspection: ________________
Report of Assembly FD 2579 # _________ _______
SCHEDULE
All manuals are present
Test instruments as required
Voltmeter
mAmeter
Pulse counter
Any mechanical damage noticed
All labels are present and legible
All indicator lights are OK
Radiation indicator X-ray lights up, audible buzzer OK
Deadman feature OK
Power supply adequate
kV – Verification is OK
Tube current is within specified limits
Specified exposure time, panoramic (pulses) OK
Specified exposure times, ceph (average pulses) OK
X-ray beam position, panoramic OK
X-ray beam position, ceph OK
Phantom radiograph, line distances within tolerance
The unit is in compliance with MFG specified tests and safety
Technician: ________________
D3285.103.04.02.02 03.2009
___________________________________
Manufacturer Model
Yes No
Accuracy Last calibrated
Line voltage: . . . . . . . . . .V
Voltage drop: . . . . . . . . . V
Measurement: . . . . . . . mA
Pulse count: . . . . . . . . . . . . . .
1. Average pulse count: . . . . . .
2. Average pulse count: . . . . . .
Dealer: ___________________
Remarks
59 01 603 D3285