Periodic Inspection
www.liko.com
95
6.0
Lift type:
.........................................................................
Prod. No:
.........................................................................
Serial No: .........................................................................
Prod. Year: .........................................................................
Customer references
Agreement No: .....................................................
Name: ....................................................................
Address: ................................................................
Post code: ............................................................
Inspection performed in accordance with ISO 10535:2006 Annex B- Periodic inspection
Approval to use the mobile lift
Approved
Not approved
Not approved:
If the mobile lift has one or more check points with result “Not approved” the mobile lift must not be used.
To be actioned:
Actions according to the “Instructions for the check points” should be performed immediatley. After performed actions sign
below. If anything is unclear or if you have questions, please contact Hill-Rom/Liko or your local Hill-Rom/Liko representative.
Contact information is to be found at www.liko.com.
Inspection performed by: _____________________________________ Date: ______________________
Final approval by:
________________________________________ Approval date: _____________
Next inspection:
________________________________________
Periodic Inspection
2012-1
1-13
Prod. No.
Golvo
7000 ES
Golvo
7007 ES
Golvo
7000 ES
Classic
Golvo
7007 ES
Classic
Golvo
7007
LowBase
2000009
2000010
2000050
2000051
2000061
The patient lift must be thoroughly inspected at least once per year.
Inspection and service must be carried by Hill-Rom/Liko authorized personnel.
Instructions for check points, from next page.
Check points:
Approved Not
To
be
actioned
approved
General inspection
1
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................................................................................
2 Inspection of the lift
................................................................................
Base
3 Castor wheels and forks
................................................................................
4 Castor brakes
................................................................................
5 Stop screw
................................................................................
6 Base opening and closing
................................................................................
Mast
7 Base attachment secure screws
................................................................................
8 Armrest
................................................................................
9 Lift arm hardware and covers
................................................................................
10 Inspect Lift strap
................................................................................
11 Sling bar bearings and safety latches
................................................................................
12 Battery and electrical cable installations
................................................................................
13 Hand control
................................................................................
14 Emergency Stop function
................................................................................
15 Electrical emergency-lowering device
................................................................................
16 Charger function
................................................................................
Load Testing
17 Mast Max. Load Test
................................................................................
18 Base Max. Load Test
................................................................................
19 Mechanical Em. Lowering Load test
................................................................................
Documentation
20 Instructions/Instruction Guide
................................................................................
Содержание 2000009
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