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Hologic Faxitron Path
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FAXITRON PATH USER MANUAL | HOLOGIC | REVISION 024
S
ECTION
S
chedule of
Maintenance
8
8 - 8
PeriodicMaintenenceRecord‐FaxitronPath
SystemS/N: _______________ CameraS/N: ______________ 

Theperiodicmaintenanceidentifiedabovewascompletedby: ____________________________________
DateCompleted: ______________ Signature:_______________________________________________
SafetyInterlocksandIndicators–perSection8.8.0
Pass:_____ Fail: _____ Initials:_____________ Date:_______________
Iffailed,statethereasonandtheactionstakentocorrectthefailure.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Initials:_____________ Date:______________
ACRPhantomTest–perSection8.8.1
Numberofobjectsobserved: Masses:______ Fibers:______ CalcificationGroups: _____
Pass:_____ Fail: _____ Initials:_____________ Date:_______________
Iffailed,statethereasonandtheactionstakentocorrectthefailure.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Initials:_____________ Date:______________
RadiographicSurvey–perSection8.8.2
RadiationReadingsin: mR/hr µSv/hr CheckSource : _____ Background: ______
Front:_______ RightSide: _____________ Top:_______________
Back:________ LeftSi de:_______________ Bottom:____________
Pass:_____ Fail: _____ Initials:_____________ Date:_______________
Iffailed,statethereasonandtheactionstakentocorrectthefailure.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Initials:_____________ Date:______________

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