Weinmann Oxygen MODULE - Interface Module Log

48 Repair and inspection log
11.4 Interface MODULE
Device master data Inspections and repairs carried out in accordance with the service instructions
Manufacturer: Weinmann GmbH + Co.
22525 Hamburg
Measures / Comments
Service performed in accordance
with MODULE service instructions
Company
_____________ __________________
Date Signature
Device model: Interface MODULE ❐ WM 22290 with Walther coupling ❐ WM 22280 with AGA coupling ❐ WM 22270 with Shraeder-Valve coupling
Company
_____________ __________________
Date Signature
❐ WM 22230 with Dräger coupling Serial no.: _________________________ Date of manufacture: ________________
Functional check:
Company
_____________ __________________
Date Signature
Before each use ____________________ After each use _____________________
Company
_____________ __________________
Date Signature
Every 6 months ____________________ After every repair __________________