Preventive Maintenance Checklist
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1Preventive Maintenance Checklist
Technician Info:
Doctor Info:
Company Name ____________________________________________________
Company Name ________________________________________________
Name_______________________________ ______________________________
Doctor Name __________________________________________________
Preventive Maintenance Completion Date:________________________________
Address ______________________________________________________
Counter Reading (Lease Customer Only) In___________Out_________________
City__________________________________________________________
State_________Zip________________Phone_________________________
Machine Info:
Machine Serial #_____________ ____ Tubehead Serial # _________________
Machine Type:
PC-3000
PC-4000
1.
Visual Inspection
Tubehead Serial Match
Pass
Fail
N/A
Action Taken________________________________________
Mirror
Pass
Fail
N/A
Action Taken________________________________________
Data cable properly routed (PC-4000)
Pass
Fail
N/A
Action Taken________________________________________
Exposure Button Assembly
Pass
Fail
N/A
Action Taken________________________________________
Forehead Support Knob
Pass
Fail
N/A
Action Taken________________________________________
Forehead Support
Pass
Fail
N/A
Action Taken________________________________________
Handlebars (Free of Movement)
Pass
Fail
N/A
Action Taken________________________________________
2.
Display Panel
Keypad Buttons
Pass
Fail
N/A
Action Taken________________________________________
VFD Display Readout
Pass
Fail
N/A
Action Taken________________________________________
3.
Darkroom and Processing Analysis (Film and Plate Systems Only)
Light in darkroom
Pass
Fail
N/A
Action Taken________________________________________
Timer
Pass
Fail
N/A
Action Taken________________________________________
Thermometer
Pass
Fail
N/A
Action Taken________________________________________
Intensifying Screens
Pass
Fail
N/A
Action Taken________________________________________
Black Cassette
Pass
Fail
N/A
Action Taken________________________________________
Screen Type
Ektavision
Lanex
X-Omat
N/A
Film Type
i. Manufacturer: _______________________ ii. Model: ____________________________ iii. Speed: ____________________________
4.
Stability Of Unit
Unit is level/free of wobble
Pass
Fail
N/A
Action Taken________________________________________
5.
Inspect Screw Drive Motor
Pass
Fail
N/A
Action Taken________________________________________
6.
Arm and Film Drum Rotation
Arm Drum
Pass
Fail
N/A
Action Taken________________________________________
Film Rotation
Pass
Fail
N/A
Action Taken________________________________________
7.
Tubehead Inspection
Tubehead Leaking?
Pass
Fail
N/A
Action Taken________________________________________
8.
Calibrate/Verify Calibration
Line Voltage _____________________________
mA _________________
If Serviced: _____________________
KVP CAL 89 VAC_______ 104 VAC _________
If Serviced: 89 VAC __________ 104 VAC __________
Pulse Count ______________________________
If Serviced, new pulse count: _______________________
9.
Panoramic Beam Alignment
Pass
Fail
N/A
Action Taken________________________________________
10.
Software Calibrations (PC-4000 Only)
Mechanical Alignment
Pass
Fail
N/A
Action Taken________________________________________
Software Calibrations
Pass
Fail
N/A
Action Taken________________________________________
11.
Pin Test
Measurement Right ________________________ Measurement Left ________________________
Pass
Fail
N/A
Action Taken________________________________________
Additional Comments and Recommendations:
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
Panoramic Certified Technician Signature: ___________________________________________________ Date: _______________
Customer Signature: _________________________________________________ Date: _______________
Panoramic Corporation (Original) - Technician (1 copy) - Customer (1 copy)
Form 7433
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Parent category: Life