1st year
Date: .............................................
Number of hours: ..........................
Technician's name: .....................
......................................................
Signature
and
stamp:
3rd year
Date: .............................................
Number of hours: ..........................
Technician's name: .....................
......................................................
Signature
and
stamp:
5th year
Date: .............................................
Number of hours: ..........................
Technician's name: .....................
......................................................
Signature
and
stamp:
7th year
Date: .............................................
Number of hours: ..........................
Technician's name: .....................
......................................................
Signature
and
stamp:
2nd year
Date: .............................................
Number of hours: ..........................
Technician's name: .....................
......................................................
Signature
and
stamp:
4th year
Date: .............................................
Number of hours: ..........................
Technician's name: .....................
......................................................
Signature
and
stamp:
6th year
Date: .............................................
Number of hours: ..........................
Technician's name: .....................
......................................................
Signature
and
stamp:
8th year
Date: .............................................
Number of hours: ..........................
Technician's name: .....................
......................................................
Signature
and
stamp:
YL033700 - Rev. 3a - 2019-02
Maintenance form
OSIRIS 3 No.: ..................................................................
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In service on : ...........................................................
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Maintenance assured by: ................................................
...........................................................................................
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Your distributor: ...............................................................
...........................................................................................
Address: ...........................................................................
... .......................................................................................
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Telephone : .......................................................................
... .......................................................................................
Preventive maintenance of equipment must be done
according to instructions given by the manufacturer in
maintenance manuals and possible updates.
Operations must be performed by technicians who
have received appropriate training.
Use only original spart parts.
On request, the supplier will make available: circuit
diagrams, component lists, technical descriptions,
or any other information useful to qualified technical
personnel, to repair parts of the equipment stated as
repairable by the manufacturer.
Air Liquide Medical Systems
Parc de Haute Technologie
6 rue Georges Besse CE 80
92160 Antony - FRANCE
Tel : 33 (0)1 40 96 66 00
Fax : 33 (0)1 40 96 67 00
Website:
www.device.airliquidehealthcare.com
Hotline:
ALmedicalsystems.services@airliquide.com
Appendix - EN
31