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Preventive maintenance and security controls
Date intervention :
Service provider's stamp
Name of establishment referent
Brand :
Model:
Equipment no. :
Manufacturer series no. :
Checking the cylinder/lifting arm assembly
1
Checking the cylinder/mast assembly
2
Checking the mast/lifting arm assembly
3
Checking the mast/ crusher assembly(s)
4
Checking the mast/ handlebar assembly
5
6
Checking wheel fixing
Checking sub-patellar support fixation
7
Checking sling suspension hooks
8
Check structural condition and paintwork
9
Check Pedal or Foot Spacer Assembly
10
Checking the foot spacer system
11
Checking left and right foot assemblies
12
Check lifting cylinder operation
Check remote control (function and status)
Check control box (emergency stop button, etc.)
Battery check (3 complete cycles)
Optional : Checking operation of foot spreader cylinder
Observation
Breakage Customer misuse
Wear
Equipment replaced by N°.
Checks done on:
Installation Guide / Stand-up: WAYUP 5 Manufactured by NAUSICAA Médical S.A.S. / Approved by Ghizlane Labrosse (Biomedical
20
Description
Additional checks for models with opening legs :
Checks made by:
First name and surname of consultant
Room number :
Leased equipment :
Owned equipment :
Compliant
Engineer)
Not compliant
Diagnostic
Scheduled date of next check:
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