Barkey Autoline XPT 4R Inspection Log for Technical Safety Inspections Ver 2 GB

Inspection log for technical safety inspections (TSI) Owner:

_______________________

Serial number:

_________________________

_______________________

Start-up:

_________________________

_______________________

Date:

________________________

Internal Device-ID-No. (Owner): NOTE:

Barkey autoline XPT 4R

___________________________________________________

The following checks must be carried out every 12 months on this device. They may only be carried out by persons who are competent in this field due to training.

Barkey autocontrol 3XPT controller part Serial number:

_______________________

Calibration date: _____________________ not OK

OK

1. Visual inspection – Damage to warming device – External damage to connecting cables or to connecting plug – Signs of overloading or improper handling – Inadmissible access and alterations – Soiling and corrosion affecting safety – Legibility of labelling – Condition and functional safety of fixing elements

2.

Temperature check Reference thermometer:

____________________________

Room temperature:

(20°C …28°C )

____________________________

-

Reference temperature head:

(*1)

_________ °C

-

Temperature display chX a (head): (Ref. head ± 1,0°C)

_________ °C

-

Reference temperature end:

(*1)

_________ °C

-

Temperature display chX b (end):

(Ref. end ± 1,0°C)

_________ °C

(*1) One of both reference temperatures must amount to 43,0 ± 1,0°C. The other reference temperature may be well below 43,0°C. 3.

Measurements in accordance with EN 62353: 2008-08 Applied parts: CF

al-201-SV-0011-05/V2 GB page 1

Testing device:

____________________________

– Insulation resistance:

(RISO ≥ 70 MΩ)

_________ MΩ

– device leakage current:

(∆I ≤ 100 µA)

_________ µA

– Patient leakage current:

(IEPA ≤ 50 µA)

_________ µA