Workshop Service Report

Canon Medical Systems Europe BV

Service Request #: N/A Date in: 21-03-2022

System/Product: Customer:
Serial number main unit: 300117 Dealer:
Model name: OCT-HS100/EU Country: #N/A
Accessories: PC, Cables, Lens Cap, EL-1 ITRP call: Email
Condition of packing: Wooden crate. Poor packaging. Reporting engineer: End-user
Canon engineer: Piter Rooij Failure date:
Investigation date: 01-03-2022 Date of last calibration: 22-05-2016
RMA number: N/A
Warranty condition: Out of warranty

Reported failure:
SLO_SOCT_Shutter_Errors

Investigation report:
Unit packed in wooden crate: caused some minor damage to the Chin Rest Front Cover. Replacement maybe not necessary, see below
conclusion. Replace SOCT Shutter Unit. Sensitivity: 28.4 (minimum 30, nominal >45). Replace Polygonal Scanner Unit. Clean optical path fully.
Calibrate unit fully. Check functioning. Unit to be returned in original OCT box to prevent transport damage.
Used tools:
Identification # Last calibration/ inspection date Identification # Last calibration/ inspection date
31-I-842 Safety tester 31-O-1098 Tool Q1
31-O-1119 PM100D 31-O-1105 Tool R
31-O-1087 PM120S 31-O-1097 Tool S
31-O-1107 Tool C3
31-O-1096 Tool D
Parts used:
Part number Description Quantity Price Total
BY3-0070-030 Polygonal Scanner PCB 1 € 1 827,68 € 1 827,68
BH7-9432-000 SOCT Shutter Unit 1 € 1902,00 € 1902,00
OCT-HS100/A1 Carton Box OCT-HS100/A1 Carton Box 1 € 417,51 € 417,51

Small parts and disposals 1 € 95,00 € 95,00

Shipping Costs 1 € 210,00 € 210,00
Inspection Costs € 160,00 € 0,00
Labour hours 22 € 160,00 € 3 520,00
Total amount: € 7 972,19
Conclusion:
Please let us know if you'd like to replace the Chin Rest Front Cover or not. Additional costs for this: € 132.42

CMSE will investigate and repair as mentioned in this report. Dealer agrees that all repairs and investigation cost below Euro 750,-
(including labour, parts, etc, but not limited to) will be charged without signature. Estimated repair cost above Euro 750.- needs
dealers' signature before repair will be carried out.

Signature customer:

Date:

Warranty in case of repair and/or refurbishment: Workmanship and materials are warranted for 6 months to be free from defects under normal use.
CMSE obligation is limited to rework (same defect) only provided if the equipment is accompanied with this copy and returned to CMSE with detailed defect description.
This warranty is void on any item or parts that have been tampered with by unauthorized persons, misused, neglected or damaged.