Canon ImageRunner 5000 Series User Manual page 522

Check Sheet for the Periodic Inspection of the
Breaker
This page should be cut out of the user's guide and copied for future use.
After cutting out of the user's guide, store this page in a safe place near the machine.
How to Inspect the Breaker periodically
Follow the procedure described in the "Periodic Inspection of the Breaker" on p. 26 of the
imageRUNNER 5000 Series User's Guide, once or twice a month.
How to Fill in this Check Sheet
Fill in the date of inspection, and the name of inspector.
When the inspection finished normally, write a check mark under "OK".
If not, contact your service representative. (Also write a check mark under "NG".)
Date of
Inspector
Inspection
Result
Date of
Inspection
OK NG
Result
Inspector
OK NG