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San Joaquin General Hospital 002856PDATE�iq <br />BIOMEDICAL SERVICES SERVICE REPORTa� <br />TYPE PM -1 El Repair -2 Contract -3 Initial Insp.-4 Demo. Insp.-5 Warranty -6 <br />Third Part -7 Project -8 -9 -0 Change <br />I.D. NO. Mfr. -t lal <br />Model p <br />:�'1-5220 Inti lea(_ O ED(—iL_I-_ I ON <br />SN Description <br />66 1 S,TERL-IZEFti <br />Dept. Location Cost Center <br />L -(i B9t i ;t <br />Lr-M"UC l,VnnCly 1 <br />LJ Accessories <br />Cable/Cord Lamp/Indicator <br />PM <br />Alarms <br />�O <br />UOCU <br />❑ Display IDOdor <br />,� �t_ },., 2 4 PM Complete <br />❑ Noisy ❑ No Output [:]Hot a.. <br />vU <br />Shock <br />SYSTEM COMPONENTS <br />QTY. <br />DESCRIPTION <br />PART NO. <br />I.D. NO, DESCR. TIME <br />SERVICES PERFORMED <br />1.1DU5ItSMOUNTIRG <br />_� <br />NOTORIPUMPIFAN <br />2 <br />>t_un ASSM7 <br />DOOR BASKET <br />1NDICATORS/DDS; LAYS <br />ELECTRODES <br />LEAKAGE LEAD <br />_l <br />TRAPS <br />3 <br />CALIBRATION <br />_Z <br />S f -t o <br />IL Ul t t <br />r A <br />4 <br />GAUGES <br />CLEAN <br />_ <br />❑ SINK <br />LHAXI E ft <br />tof Fica aey <br />_-- <br />Lr-M"UC l,VnnCly 1 <br />I CJ I <br />nCliUiiVU <br />MIA I CrSWLJ <br />UOCU <br />vU <br />QTY. <br />DESCRIPTION <br />PART NO. <br />COST <br />CASE r A <br />❑ PWR ON <br />❑ PWR OFF ❑ Rev <br />2 <br />ELECTRODES <br />LEAKAGE LEAD <br />3 <br />r A <br />4 <br />❑ SINK <br />❑ REV ❑ SOURCE <br />5 <br />GND RES OHMS/100 <br />6 <br />PROBLEM: None -0 <br />Q <br />Display -1 <br />Output -2 <br />Non -Functional -3 Broken -4 <br />Total <br />Interference -5 <br />D <br />Adjustment -6 <br />Ej Dirt -7 <br />-8 Other <br />FAILURE: ❑ None -0 <br />❑ <br />Cord/Pt Cable -1 <br />❑ Operator -2 <br />❑ Component -3 ❑ P.C. Board -4 <br />Labor <br />Cost <br />echanical-5 <br />Cal/Adjust-6 <br />Accessories -7 <br />El Loaner -8 Other -9 <br />TIME <br />DATE <br />TECHElREPAIR <br />REQUIRED <br />REPAIR P.O. # <br />VENDOR <br />VENDOR HRS. <br />S.O. # <br />PMSTATUS <br />PM # <br />OTHER <br />2 J F M 2A I M J <br />2 J I A I S 2O N D <br />24 <br />A A I C I <br />M I N R <br />SERVICE VENDOR <br />CONTRACT EXP. <br />❑ Biomedical ❑ Other: <br />/ <br />PURCHASED DATE <br />LEN WARRANTY (Months) <br />P.O. No. <br />COST <br />YR. MO <br />1 3 <br />VENDOR <br />❑ Same As Mfr. ❑ Other: <br />ASSET NO. <br />1 <br />2 <br />EST. HRS. <br />DEDUCT <br />C t <br />�.„t' <br />11:1100 <br />❑ <br />t000 <br />f vvorK vraers o I otai Hours Total Parts Cost Total Labor Cost Total Repair Cost Cost Ratio Last Service <br />4.6 0 <br />-7 C' G 150' <br />' y — 1 <br />❑ DP ❑ BMS <br />