C-1
C BeneHeart D1 User Checklist
Inspect the equipment as recommended. Place a “√” in the “Pass/Fail” box as you check the item , or place a “-” if not
applicable. Describe the problem if there is any abnormity.
Equipment Name: Serial Number: Department:
Item Requirements Pass/Fail Description of Abnormity
Equipment/Accessory
appearance
Clean, no foreign substance, no crack
Battery Battery installed and available
Pads Pre-connected to the equipment, with
intact package, and within validity
Service indicator Lit and green
Checked by: Date:
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