ELECTRICAL SAFETY INSPECTION A-15
ELECTRICAL SAFETY INSPECTION FORM
(Class I equipment)
Overall assessment:
Test item: 1, 2, 3, 4, 5, 6, 7
Opened repair type, not modify the power part including
transformer or patient circuit board
Opened repair type, modify the power part including
transformer
Opened repair type, modify patient circuit board
Test item: 1, 2, 3, 4, 6, 7
Measurement equipment /SN:
Device Enclosure and Accessories
Protective Earth Resistance
NC: 300μA(refer to
UL60601-1) *
NC: 500μA(refer to
IEC60601-1) *
SFC: 1000μA
Single Fault
condition(SFC)
BF applied part:
NC:100μA, SFC:
500μA
Single Fault
condition(SFC)
Mains on Applied Part
Leakage
Functional test (parameters tested):
Note:
The equipment which sell to America shall comply with the requirement of
UL60601-1, others shall comply with the requirement of IEC60601-1.
Name/ Signature: ____________________ Date: _____________________________