Information
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Document No.
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Audit Title
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Client / Site Name:
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Site Address:
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Conducted on
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Requested by:
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Prepared by
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Personnel attending:
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Facility description
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General reason for visit:
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Current Linac:
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Photo of current linac
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Current top energy:
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Proposed replacement System:
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General discussion:
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Customer expectations:
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Follow ups:
Vault Parameters
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Vault door width and height:
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ISO to back wall:
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ISO to patient foot:
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ISO to A-side:
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ISO to B-side
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Quick drawing of vault:
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Photo of existing vault
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Ceiling height:
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Control room location:
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Control room width:
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Control room depth
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Photo of control room
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Control room drawing
MEP
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Current chilled water supply:
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City water backup?
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Current electrical supply? Include location, ampacity, voltage.
Rigging
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General description of path. General length, hall width, door width & height.
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General description of staging area:
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Photo of staging area:
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Standard delivery?
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Does this delivery fall under standard delivery?
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Dock or ground delivery?
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Explain why rigging does not fall under standard rigging.
