20
Annual Service Inspection, Rise II
Service Contract No.:
Product:
12B40, Rise II, Shower & Commode
Product:
12B40, Rise II, Shower & Commode
Product:
12B40, Rise II, Shower & Commode
Department / User:
Department / User:
Department / User:
Telephone:
Telephone:
Telephone:
Service Inspection performed by:
Date:
Control point:
Description:
A
ll r
igh
t:
L
ubr
ic
at
ed
N
o
is
e /
Irre
gu
la
ri
ty
T
ight
ene
d:
Co
m
m
en
t N
r.:
Release of seat tilt
Locks
Release of seat tilt
Releases “ball” is not loose
Release of seat tilt
Release mechanism securely fastened
Hydraulic tube
Intact and secured with strips
Gas springs
Securely tightened
Backrest
Securely tightened
Seat
Easy to remove and put back on the chair
Seat
PU-surface is intact
Arm rests
Securely fastened and move smoothly
Arm rests
PU is intact
Foot plates on footrests
Fold up/down, securely fastened
Footrests
Height-adjustability works
Footrests
Easy to remove
Emergency Stop
Works and releases again
Lifting mechanism
Lifts from bottom to top whit full load
Actuator
Correctly mounted / Locking rings in place
Actuator
O-Ring intact., greased &correctly inserted
Actuator
No signs of water ingression
Hand Control
”Hold to activate” works
Hand Control
Charging- & Activity lights work
Hand Control
O-Ring intact., greased &correctly inserted
Wall Charging Station
Intact & correctly mounted on the wall
Wall Charging Station
Gold-plated contacts are intact
Electronics- & Control Box
No signs of water ingression
Electronics- & Control Box
Charging- & safety cycles work correctly
Electronics- & Control Box
Is correctly mounted
