(R) Notes (defects found, repairs perfor-
med or other relevant information)
(S) Check results.
O
Device suitable for use.
O
Device not suitable for use.
O
Device to be checked.
O
Device suitable for use.
O
Device not suitable for use.
O
Device to be checked.
O
Device suitable for use.
O
Device not suitable for use.
O
Device to be checked.
O
Device suitable for use.
O
Device not suitable for use.
O
Device to be checked.
O
Device suitable for use.
O
Device not suitable for use.
O
Device to be checked.
O
Device suitable for use.
O
Device not suitable for use.
O
Device to be checked.
O
Device suitable for use.
O
Device not suitable for use.
O
Device to be checked.
O
Device suitable for use.
O
Device not suitable for use.
O
Device to be checked.
O
Device suitable for use.
O
Device not suitable for use.
O
Device to be checked.
O
Device suitable for use.
O
Device not suitable for use.
O
Device to be checked.
- 43 -
(T) Date of
next check.