Information

  • Document No.

  • Audit Title

  • Client / Site Name:

  • Site Address:
  • Conducted on

  • Requested by:

  • Prepared by

  • Personnel attending:

  • Facility description

  • General reason for visit:

  • Current Linac:

  • Photo of current linac

  • Current top energy:

  • Proposed replacement System:

  • General discussion:

  • Customer expectations:

  • Follow ups:

Vault Parameters

  • Vault door width and height:

  • ISO to back wall:

  • ISO to patient foot:

  • ISO to A-side:

  • ISO to B-side

  • Quick drawing of vault:

  • Photo of existing vault

  • Ceiling height:

  • Control room location:

  • Control room width:

  • Control room depth

  • Photo of control room

  • Control room drawing

MEP

  • Current chilled water supply:

  • City water backup?

  • Current electrical supply? Include location, ampacity, voltage.

Rigging

  • General description of path. General length, hall width, door width & height.

  • General description of staging area:

  • Photo of staging area:

  • Standard delivery?

  • Does this delivery fall under standard delivery?

  • Dock or ground delivery?

  • Explain why rigging does not fall under standard rigging.

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