• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel


  • Top surface

  • Behind headrest

  • Side panels

  • Under arm rest

Bracket table

  • Under tray and rim

  • Side edge

  • Top surface

Switch panel

  • Below switch panel

  • Bottom surface

  • Top surface

Hand piece Bracket

  • Outer surface

  • Hand piece cradle and buttons

  • Hand piece tubing


  • Arm

  • Light cover and switch

  • Handles

Bench Tops

  • Clean area

  • Contaminated area

  • Clerical area

Suction Bracket

  • Outer surfaces

  • Underneath

  • Hand piece cradle and buttons

  • Hand piece tubing


  • Inner bowl & upper ridge

  • Suction filter

X-ray Unit

  • Cone

  • Head

  • Arm

  • Trigger Button

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