B
I
PAP S
YNCHRONY
S
ERVICE
& T
ECHNICAL
I
NFORMATION
1032447, R
EV
. 00
T
ESTING
& C
ALIBRATION
- P
AGE
22
P
ERFORMANCE
V
ERIFICATION
D
ATA
S
HEET
Serial No: ____________________________
Model Number:________________________
Line Voltage: __________________________
Blower Hours:__________________________
CPAP Mode Pressure Settings:
3b) 4 cm H
2
O____________(3-5 cm H
2
O)
3c) 20 cm H
2
O___________(18-22 cm H
2
O)
3e) Synchrony Mode Trigger Performance: Pass/Fail___________
3j) Ramp Performance Bi-Level:
Pass/Fail___________
3g) S Mode Trigger Performance:
Pass/Fail___________
Humidifier Testing:
Pass/Fail___________
Name (print)____________________
Signature (In Ink)_________________ Date:_____/_____/____
NOTE
You should record all information on this data sheet after each test has been completed.
Data sheet must then be signed in ink and dated by the technician performing the test.