Form Verifikasi

LAMINAR AIR FLOW FIELD REPORT
TEST REPORT NO :
: Verification
: Re-Verivication
COSTUMER NAME : CABINET MODEL : HORIZONTAL

INSTRUMENT : : VERTICAL
BRAND : S/N :
TYPE : DATE OF TEST :
TEST 1. AIR VELOCITY

Velocity Test Site Test Data
1 2 3 4 5 6
• • • • • •
Position Left Side
m/s m/s m/s m/s m/s m/s
• • • • • •
Rear
Center
Front
• • • • • •
Min Velocity : m/s
Max Velocity : m/s
Average Velocity : m/s
Within Tolerance ± 20% : PASS / FAIL
Acceptance Criteria
1. Average Air Velocity : 0.40 m/s - 0.50 m/s
2. All Individual Velocities : The Individual point readings that do not vary more than ± 20% of the average air velocity
Meet Acceptance Criteria : YES / PASS
( According to NSF 49 ) : NO / FAIL
TEST 2. LIGHT INTENSITY TEST

Test Data
From the Left Side Wall 1 2 3 4 5 6
Background (LUX)
Light On (LUX)
Average Background : LUX
Average Light On : LUX
Acceptance Criteria
1. Average light intensity shall be no less than 480 LUX greater than backgroung levels, where background light levels average a max. of 160 LUX
TEST 3. ULTRAVIOLET LAMP TEST

Test Data
Measured Lamp Intensity ………………………………………………..Micro Watts/cm²
Acceptance Criteria
1. The measured lamp intensity should be greater than the minimum intensity of 100 micro watts/cm ² for a new lamp
2. The ultraviolet lamp should be replaced when the lamp's intensity drops to 40 micro watts/cm ²
TEST 4. NOISE LEVEL TEST Table N-1.1 Correction chart for sound level readings
Test Data
Difference between total and
Number to subtract from total to
background sound readings in
Left Center Right yield corrected noise level
Measure Noise (Db) dbA
0 to 2 reduce background levels

3 3
4 to 5 2
6 to 10 1
> 10 0
Accepted Criteria
The measured noise level should be less than 67 dbA
TEST 5.VIBRATION TEST

Test Data
Measured Vibration
…………………………………...……………………
Acceptance Criteria
The measured vibration level should be less than 2 X 〖inch
10 ( 5 X 〖m10
) RMS amplitude at 10 to 1,000 Hz in the center of the work surface(s)
Meet Acceptance Criteria : YES / PASS 〗 ^(
〗 ^(
( According to NSF 49 ) : NO / FAIL−4) −5)
TEST 6. DIFFERENTIAL TEST

Test Data
Measured differential
………………………………………………………………
Acceptance Criteria
The measured differential should be less than 2 inch (500 Pa)
COMMENTS : REMARKS /RECOMMENDATIONS :

ORDER CODE
PT. INTERCAL TEKNIK SOLUSINDO
FORM VERIFICATION : LAMINAR AIR FLOW BIO SAFETY CABINET FUME HOOD
COSTUMER NAME : CABINET MODEL : HORIZONTAL New Verification
: VERTICAL
MERK : S/N : Re-Verivication
TYPE : DATE VERIFICATION :
ROOM TEMPERATURE : ~ ˚c
ROOM HUMIDITY : ~ %
TEST 1. AIR VELOCITY

Velocity Test Site Test Data
1 2 3 4 5 6
• • • • • •
Position Left Side
m/s m/s m/s m/s m/s m/s
• • • • • •
Rear
Center
Front
• • • • • •
Min Velocity : m/s
Max Velocity : m/s
Average Velocity : m/s
Within Tolerance ± 20% : PASS / FAIL
Acceptance Criteria
1. Average Air Velocity : 0.40 m/s ~ 0.50 m/s
2. All Individual Velocities : The Individual point readings that do not vary more than ± 20% of the average air velocity
TEST 2. LIGHT INTENSITY TEST

Test Data
From the Left Side Wall 1 2 3 4 5 6
Background (LUX)
Light On (LUX)
Average Background : LUX
Average Light On : LUX
Acceptance Criteria
1. Average light intensity shall be no less than 480 LUX greater than backgroung levels, where background light levels average a max. of 160 LUX
TEST 3. ULTRAVIOLET LAMP TEST

Test Data
Measured Lamp Intensity ………………………………………………..Micro Watts/cm²
Acceptance Criteria
1. The measured lamp intensity should be greater than the minimum intensity of 100 micro watts/cm² for a new lamp
2. The ultraviolet lamp should be replaced when the lamp's intensity drops to 40 micro watts/cm²
TEST 4. NOISE LEVEL TEST Table N-1.1 Correction chart for sound level readings
Test Data
Difference between total and
Number to subtract from total to yield
background sound readings in
Left Center Right corrected noise level
Measure Noise (Db) dbA
0 to 2 reduce background levels

3 3
4 to 5 2
6 to 10 1
> 10 0
Accepted Criteria
The measured noise level should be less than 67 dbA
Personil In Charge : CHECKED BY : NO FORM FO-001/LBS/ITS

Signature Signature REALESED DOC 01/08/2022
REVISION `00
NO FORM : FO-001/VER/LBF
PIC BY / SIGNATURE CHECKED BY / SIGNATURE
DATE OF ISSUE : August 1, 2022
REVISION : 0
ORDER CODE
Signature Signature
REVISION : 0
ORDER CODE
TEST 5.VIBRATION TEST

Test Data
Measured Vibration
…………………………………...……………………
Acceptance Criteria
The measured vibration level should be less than 2 X 〖 10inch ( 5 X 〖m10) RMS amplitude at 10 to 1,000 Hz in the center of the work surface(s)
Meet Acceptance Criteria : YES / PASS 〗 ^(
〗 ^(
( According to NSF 49 ) : NO / FAIL−4) −5)
TEST 6. DIFFERENTIAL TEST

Test Data
Measured differential
………………………………………………………………
Acceptance Criteria
The measured differential should be less than 2 inch (500 Pa)
COMMENTS : REMARKS /RECOMMENDATIONS :
Personil In Charge : CHECKED BY : NO FORM FO-001/LBS/ITS
Signature Signature
REALESED DOC 01/08/2022
REVISION `00
REVISION : 0

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LAMINAR AIR FLOW FIELD REPORT

COSTUMER NAME : CABINET MODEL : HORIZONTAL

TEST 1. AIR VELOCITY

TEST 2. LIGHT INTENSITY TEST

TEST 3. ULTRAVIOLET LAMP TEST

0 to 2 reduce background levels

TEST 5.VIBRATION TEST

TEST 6. DIFFERENTIAL TEST

COMMENTS : REMARKS /RECOMMENDATIONS :

PT. INTERCAL TEKNIK SOLUSINDO

TEST 1. AIR VELOCITY

TEST 2. LIGHT INTENSITY TEST

TEST 3. ULTRAVIOLET LAMP TEST

0 to 2 reduce background levels

Personil In Charge : CHECKED BY : NO FORM FO-001/LBS/ITS

PT. INTERCAL TEKNIK SOLUSINDO

TEST 5.VIBRATION TEST

TEST 6. DIFFERENTIAL TEST

COMMENTS : REMARKS /RECOMMENDATIONS :

Personil In Charge : CHECKED BY : NO FORM FO-001/LBS/ITS

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