Preventive Maintenance & Security Controls
STAND-UP LIFT PREVENTIVE MAINTENANCE
Date of intervention:
Stamp of the service provider:
Name and first name of the service agent:
Name of the referent institution:
Room number :
Brand:
Model:
Equipment number:
Manufacturer serial number:
□
Leased equipment
□
Equipment belonging to the
establishment
DESCRIPTION
Conform
Non-
conform
Diagnostic
Actuator / lifting arm assembly check
Actuator / mast or base assembly check
Mast / lifting arm assembly check
Mast / base assembly check
Mast / handlebar assembly check
Castors fixation check
Slide of under patella support check
Sling fixation hooks check
State of the frame and of the painting check
Additional checks for models with opening base legs
Foot pedal or opening legs actuator check
Spreaded legs system check
Assemblies of the right and left feet on the base check
Lifting actuator operation check
Remote control check
Control box check (emercgency button, plugs)
Battery check (please perfome 3 complete cycles)
Opening legs actuator operation check
Observations
o
Breakage/misuse mauvaise utilisation du client
o
Wear
o
Replaced by N°
Provider signature
Establishment stamp
20
Checks done on:
Checks made by:
Scheduled date of next check:
1
2
3
4
5
6
7
8
9
10
11
12
User Manual - Stand-Up Lift: WAYUP 5 Range
Manufactured by NAUSICAA Médical S.A.S. / Approved by Ghizlane Labrosse (Biomedical Engineer)
