Definium 8000 System

Planned Maintenance Checklist

Schedule A
System Installation Date:
Customer:
PM Start Date:
Address:
PM Schedule: Every 24 months
City:
– starting 6
State/Province:
months after
Country:
Installation
OTS Replacement
Task Interval Result
Replace Counterpoise Assembly Every 10 Years after first Complete Notes Not Applicable
Replace main Reel Cable installation Complete Notes Not Applicable
Table Replacement
Task Interval Result
Replace Grease Cup Every 5 Years after first installation Complete Notes Not Applicable
Test Equipment List
Type Model Serial Number Calibration Due Date

Workstation
Airflow Complete Notes
Clean PC case Complete Notes
OTS
Task Result
Check/Clean Bridge Rails, Guide Bearings & Dolly Wheels Complete Notes
Check Stationary Rail Wear Strips Complete Notes
Clean Stationary Rails/Wear Strips Complete Notes
Check Lat. Drive Belt Tension/Alignment Complete Notes
Check Long. Drive Belt Tension/Alignment Complete Notes
Check/Tighten Tube Mounting Bolts Complete Notes
Check Collimator Mounting Collar Complete Notes
Check/Tighten OTS UIF console Mounting Complete Notes
Check/Clean Counterpoise Main Cable Complete Notes
Check/Clean Counterpoise Safety Cables Complete Notes
Task Interval Result
Check & Adjust Rail Levelness Complete Notes Not Applicable
Check Bridge Anti Backlash Bearing Every 5 Years after Complete Notes Not Applicable
Check/Tighten Column-to-Carriage Bolts & first installation Complete Notes Not Applicable
Counterpoise Mounting Bolts & Carriage Axel Bolts
 Table
Task Result
Visual Inspection Complete Notes
Cabling Inspection Complete Notes
Grease Cup & Screw Inspection Complete Notes
Table Top Complete Notes
Longitudinal Bearings Complete Notes
Longitudinal Track/Rails Complete Notes
Lateral Bearings Complete Notes
Lateral Track/Rails Complete Notes
Bumper End Stops Complete Notes
Patient Hand Grips Complete Notes
Chiller
Task Result
Refill Chiller Complete Notes
Clean Air Filter Complete Notes
Calibrations, Regulatory, and Image Quality
SID Focal Spot Collimator Alignment Results
Collimator
100 cm Small Pass Fail Notes
Alignment
100 cm Large Pass Fail Notes
mR/mAs Value Pass Fail Notes Beam Quality HVL Pass Fail Notes
Table Pass Fail Notes
AEC Dose QAP Pass Fail Notes
WS Pass Fail Notes
Power & Grounds, Leakage Tests
(This item needs to be executed in USA and other countries with relevant laws and regulations.)
Voltage: mV
Critical Care & Wet Location
USA Leakage: µA
only
N/A
Voltage: mV
Customer/Country Specified Leakage: µA
N/A

Notes (if you selected Notes in any above – please complete here)

Preventive Maintenance – Completion Sign-off

Engineer Name: Date Completed: GE Reference #: