Reset Form Distribution:

1. Attachment to your Service Report

Print Form

System Check Out Protocol

OPMI LUMERA 300

APPL. N/A
 Fill out chapter 1, 3, 4, 5 and
  Installation
“Installation and Acceptance Report”
  Preventive Maintenance  Fill out chapter 2, 4 and 5
  Corrective Maintenance  Fill out chapter 3, 4 and 5
  Safety Check  Fill out chapter 4 and 5
or or
  Safety Check with local report  Fill out local Check List
  Further documents attached

(The electrical safety test must be carried out in accordance with applicable local regulations and directives.)

System Serial Number: 6137102796 Software Version Not Applicable

The printout may be obsolete. Check the SIS for the most current and approved version of this document.

Note: Any section has to be filled in by marking "N/A"(not applicable) or "OK" / "Not OK".
If you have to mark any check box "not OK", please explain in "Comments".

SM-30-0049-A07 System Check Out Protocol

Version 02, 2019-05-14 Page 1 / 10 OPMI LUMERA 300
Chapter 1

- Follow SM-30-0049 Section 02 for Initial Installation

Product accessories used Type Serial number

Installation N/A OK Not OK

All the parts/accessories are well received   
All the parts/accessories are installed successfully   

Function test
Basic: N/A OK Not OK
Even tilting of the microscope about the tilting axis   

The printout may be obsolete. Check the SIS for the most current and approved version of this document.
Balance the suspension arm for the configuration   
Check the casters and their brakes   
Adjust the movement forces of the suspension system axes   
Start the system   
Check the OPMI illumination system using the adjustment
  
pattern
Diameter approx. 65 mm   
Check uniform light distribution and sharp edge   
Check the function and uniform illumination of the filters   
Operate and check the magnification changer/zoom system   
Check and, if necessary, adjust the inclination switch   
Check the focus drive   
Check foot control panel   
Check the 50% mode switch   

System Check Out Protocol SM-30-0049-A07

OPMI LUMERA 300 Page 2 / 10 Version 02, 2019-05-14
 Optional:
XY Coupling N/A OK Not OK
Could be controlled via foot control panel   
Reset button works   

Camera N/A OK Not OK

White balance   
Zoom level set to 1.3 times   
Camera Image   
The printout may be obsolete. Check the SIS for the most current and approved version of this document.

SM-30-0049-A07 System Check Out Protocol

Version 02, 2019-05-14 Page 3 / 10 OPMI LUMERA 300
Chapter 2

S200 Floor Stand N/A OK Not OK

Check the external condition of the paint finish (scratches)   
System label with system serial number provided   
Check the gas pressure spring for defects   
Check and, if necessary, adjust the balancing of the
  
suspension arm
Check and, if necessary, adjust the friction knobs of
  
suspension arm and carrier arm
Check the 3 position pins in the suspension arm   
Check the casters and brakes   
Check the cables at the joints   

Light source and Power Supply N/A OK Not OK

Check whether the rating label is provided and legible   
Check whether LED brightness can be adjusted   
Check the power cord for physical damage   
Check the power plug can be easily inserted   

The printout may be obsolete. Check the SIS for the most current and approved version of this document.
OPMI LUMERA 300 N/A OK Not OK
Check the microscope for external damage (paint finish etc.)   
Clean the objective lens and all accessible optical components   
Check the function of the filters   
Check whether the illuminated field is evenly illuminated   
Check the diameter and sharp limitation of the illuminated
  
field
Check the function of the magnification changer/Zoom
  
system
Visual inspection of the optical components   
Check the tilt movement of the microscope   
Check the asepsis set for completeness and proper condition   
Check the function and smooth movement of the focusing
  
system

System Check Out Protocol SM-30-0049-A07

OPMI LUMERA 300 Page 4 / 10 Version 02, 2019-05-14
 X-Y coupling and Foot Control Panel N/A OK Not OK
Check the X-Y coupling for external damage   
Test all functions of the X-Y coupling   
Check the foot control panel and its cable for defects   
Test all functions of the foot control panel   

Binocular Tube N/A OK Not OK

Check the binocular tube for external damage   
Check the adjustment possibilities (inter pupillary distance,
  
etc.)
Clean the eyepieces and check whether they are securely
  
mounted
Check the eyecups   
Check the diopter adjustment   

Optional N/A OK Not OK

Check the function of other accessories   

Product accessories used Type Serial number

The printout may be obsolete. Check the SIS for the most current and approved version of this document.

SM-30-0049-A07 System Check Out Protocol

Version 02, 2019-05-14 Page 5 / 10 OPMI LUMERA 300
Chapter 3

Function test
Basic: N/A OK Not OK
Check the OPMI illumination system using the adjustment
  
pattern
Diameter approx. 65 mm   
Check uniform light distribution and sharp edge   
Check the function and uniform illumination of the filters   
Operate and check the magnification changer/zoom system   
Check the focus drive   
Check foot control panel   
Check the 50% mode switch   

Optional:
XY Coupling N/A OK Not OK
Could be controlled via foot control panel   
Reset button works   

Camera N/A OK Not OK

The printout may be obsolete. Check the SIS for the most current and approved version of this document.
White balance   
Zoom level set to 1.3 times   
Camera Image   

System Check Out Protocol SM-30-0049-A07

OPMI LUMERA 300 Page 6 / 10 Version 02, 2019-05-14
 Chapter 4

Reference “Installation and Acceptance Report”

In addition follow your national regulations and if applicable all national standards!
CZ Service Customer*

The Safety test according to EN/IEC 62353 is performed by:  

* In case the customer is responsible, no further action is required from FSE, but it is mandatory to
add this information to your service report.

Visual inspection N/A OK Not OK

(EN/IEC 62353)

All marking, labels and labeling are present, complete and legible
All protective earth connections and power cords are undamaged
All externally accessible fuses comply with the manufacturer’s
specification
The mechanical parts are undamaged
--  
No damage or contamination that may impair safety is present
The associated accessories are tested together with the ME
equipment /ME system
All accompanying system documentation is present, complete and
up to date
The printout may be obsolete. Check the SIS for the most current and approved version of this document.

Max.
Protective earth impedance N/A OK Not OK
(EN/IEC 62353) (Class I) reading

ME equipment / system with power

≤ 0.3 Ω
connector (e.g. cold condition connector)   
and detachable power cord

ME equipment / system with non-detachable ≤ 0.3 Ω

  
power cord

Permanently installed ME equipment/system ≤ 0.3 Ω

  
(e.g. ceiling mount)

ME system with multiple connector (e.g. ≤ 0.5 Ω

  
table & equipment)

≤ 0.1 Ω
Detachable power cords only   

SM-30-0049-A07 System Check Out Protocol

Version 02, 2019-05-14 Page 7 / 10 OPMI LUMERA 300
Insulation resistance (optional) Reading N/A OK Not OK
(EN/IEC 62353)

≥ 2 MΩ
Measurement at 500 VDC   

Max.
Leakage current N/A OK Not OK
(EN/IEC 62353) reading

Equipment leakage current

Differential measurement: Class I max. 500 µA   
Class II max. 100 µA

Equivalent leakage current: Class I max. 1000 µA

  
Class II max. 500 µA

Leakage current of applied parts (BF type only)

  
Direct measurement: max. 5000 µA

Function test N/A OK Not OK

(EN/IEC 62353)

Function test according to SM-30-8005-116 section 9.5

--  
incl. safety and warning functions

The printout may be obsolete. Check the SIS for the most current and approved version of this document.
Further tested
functions/parameters:
  

System Check Out Protocol SM-30-0049-A07

OPMI LUMERA 300 Page 8 / 10 Version 02, 2019-05-14
 Chapter 5

Calibration
Test equipment used Type Serial number
valid until
Safety tester as per EN 62353
or VDE 0751 or EN 60601
Calibration
Accessories used Type Serial number
valid until

Calibration
Test equipment used Type Serial number
valid until

Calibration
Accessories used Type Serial number valid until
The printout may be obsolete. Check the SIS for the most current and approved version of this document.

Calibration
Test equipment used Type Serial number
valid until

Calibration
Accessories used Type Serial number
valid until

SM-30-0049-A07 System Check Out Protocol

Version 02, 2019-05-14 Page 9 / 10 OPMI LUMERA 300
Further annexes / reports relating to the test? Yes  No 

Which:

Additional tested
Type Serial number Result
equipment

Accessories:

Rating:

 No safety or functional deficiencies were detected; functional tests successfully completed

 No direct risk; the detected deficiencies can be quickly corrected (see service report)
 Substantial safety deficiencies. ME equipment/system must not be operated!

6 12 24 36
Next repeat check is due in months or not later than
(mark as applicable)

The printout may be obsolete. Check the SIS for the most current and approved version of this document.
Comments

Oktavian Yopie
2020-11-02 Tested by Yopie Oktavian
Digitally signed by Oktavian Yopie

Date Signature X6YOK

X6YOK
Date: 2019.09.16 10:03:11 +07'00'

System Check Out Protocol SM-30-0049-A07

OPMI LUMERA 300 Page 10 / 10 Version 02, 2019-05-14