Title Page
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Title:
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Client / Site
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Address:
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Project Number:
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Conducted on
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Prepared by
Hospital contacts:
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Main hospital contact:
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Building contractor:
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Electrical contractor:
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IT administrator
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Radiation protection advisor
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Accepting Physicist:
Pre-installation notifications
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Has the hospital administration been notified of the proposed date of equipment delivery?
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Date:
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Has insurance cover been arranged for the delivery of the equipment?
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Have the authorities been informed where public are may be used for delivery?
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Any comments or considerations?
Access to the site/ off-loading area
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Is the off-loading area clear and clean?
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Has provision been made to prevent dust and debris getting in to the hospital and to the equipment?
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Will it be clear on the date of the delivery?
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What is the dimension the off-loading area?
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Is the off-loading area flat and the same height as the entrance of hospital building?
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Will arrangements be made for a shallow gradient ramp or leveled area to allow easier access of equipment?
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What is being used to off-load the equipment?
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Does the above have a SWL of 5 tones?
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Is a lockable area available for the storage of the delivered equipment and tools?
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Have arrangements been made for an installation rigging crew to be available for delivery?
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Have they experience of moving heavy equipment?
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How many people?
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Is an interpreter available during the rigging process to enable communication of site?
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Contact information:
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Is the hospital a new building?
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Has all building work been finished?
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Are there any building workers in the area up to, or inside, the treatment room or control area?
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Are any hospital staff working on access route?
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Have arrangements been made for the area to be clear on the day of delivery and following day?
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Has provision been made for disposing of, or recycling, all packages and crates?
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Any comments or considerations:
Access to the treatment room
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Can the floor withstand a point of load of 600kg?
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Is the minimum clear height on the access route to the treatment room higher than 2015mm?
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Have arrangements been made for this to be altered?
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Is the minimum clear width on the access route to the treatment room wider than 970mm?
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Have arrangements been made for this to be altered?
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Are there any corners below the recommended dimensions in the planning guide?
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Have arrangements been made for this to be altered?
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It is necessary to remove any door frames?
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Have arrangements been made for this to be altered?
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Do any floor ducts requires protection?
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Have arrangements been made for this to be altered?
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Any gradients on the route to, or inside, the treatment room?
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Comment about:
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Has the access route cleared of debris and swept clean?
Treatment Room
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Is the concrete slab a minimum of 220mm thick?
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Is the concrete slab clear of screed?
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Has a concrete core sample been tested?
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Has a copy of the test certificate been supplied?
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What is the value of compression test?
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Has the treatment room been cleared of debris and swept clean?
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Has the pit of Precise Table constructed?
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Is the pit clear of screed?
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Is the pit internal width of 1400mm?
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Is the pit internal length of > 3175mm?
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Is the pit height of 315mm?
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Is there a floor channel near the back of the technical room for cabling distribution?
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Are the steel angle frame that surround the Precise Table pit 50x50x6 mm anchored in to the concrete?
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Has the final floor been laid?
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Then the concrete must to be sealed to decrease dust. Has this been done?
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Have arrangement been made to protect the floor during delivery?
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Have the wall coverings been added?
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Have the room fittings been completed?
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Have the laser cavities protective boxes been constructed?
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Have steel plates for mounting the lasers been fitted?
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Have the CCTV infrastructure been made for installation?
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Is the ceiling finished?
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If the ceiling mounted I-section guider is being used, have the ceiling tiles been removed to give clear access to the guider?
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Is the treatment room fascia constructed?
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Is the height of the opening > 2700mm?
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Is the width od the opening > 2800mm?
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What is the lifting facilities are available?
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I-section guider attached to the ceiling?
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Has a space been left in the Fascia partition to allow the travelling hoist on the I-section guider?
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In the long axis of the guider parallel and vertically above the front/rear axis (G-T axis) of the floor cavity?
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Is the distance between the floor level and the highest point to which the hook can be raised minimum 2400mm?
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Is the maximum SWL can support 3 tones?
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Is a copy of the SWL available?
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Fascia should be built after installation, is that planned?
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Are the cable ducts finished?
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Are they cleaned of debris?
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Does the ducts meets the requirements of planning guide?
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Is the duct between treatment and control area dry? No water is allowed.
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Are pull strings installed in the duct/channel between treatment and control area?
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Is the Three-phase mains isolator in position?
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Is the three-phase electrical supply free of transitory interference?
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Phase 01:
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Phase 02:
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Phase 03:
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Single Phase:
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Has a three-phase cable been supplied from the mains isolator to the proposed position of the voltage stabilizer?
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Is there a voltage stabilizer presented, installed and calibrated by the manufacture?
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Has a three-phase cable been supplied from the voltage stabilizer to the position of interface cabinet?
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Will treatment room monitors be mounted such that the bottom edge of the TRM is more than 1800mm of height from the finished floor?
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Is the treatment monitor supports available?
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Is the HRC in position?
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Is the main door interlock connected to the HRC?
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Are the secondary doors interlocks connected to the HRC?
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Are the lasers connected to the HRC?
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Are the room lights connected to the HRC?
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Is the warning light connected to the HRC?
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Is the water chiller remote start control connected to the HRC?
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Is the emergency buttons connected to the HRC?
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Are all of the connections in the HRC correctly labeled?
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Is the air conditioning function and tested?
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State the humidity of the air inside of the treatment room:
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State the temperature of the air inside of the treatment room:
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Is a fire detector system installed in the treatment room?
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Are there hose pipes to bring the chilled water to the machine?
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Do the pipe have fittings for connecting the flexible hose?
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Is the chiller machine functional and calibrated?
Control area
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Is the control desk in position and finished?
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Have suitable cable passages been cut in the control desks?
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Are the cable ducts finished?
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Are the cables cleaned and clear?
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Are chairs available on site?
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Are cable ducts laid in to the concrete?
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Are the floor cover fit correctly?
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Do the cable ducts meets the requirements of the planning guide?
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Are all removable panels below the control desk accessible?
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Are the single-phase sockets fitted?
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Is single-phase socket powered supplied?
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Has the final floor finish been laid?
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If the final floor finish is not laid, then the concrete floor must be sealed to decrease dust, has this been done?
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Has the control area been cleared of debris and swept clean?
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Is the air conditioning functional?
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Is the final light fitted?
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Is the final lighting operational?
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Is position of the MCC and FEC clear of obstruction?
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Any comments or considerations:
Chilled water supply
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Is a standalone chiller available on site?
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Is the chiller functional and calibrated by the third suppliers manufacture?
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State the water supply temperature:
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State the water supply pressure:
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State the water return pressure:
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State the water supply flow rate:
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Are manual stop valves in position?
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Are there hose-pipes to bring chilled water to the equipment area?
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Do the pipes have fittings for connecting the flexible hose?
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Any comments or considerations:
Installation requirements
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Has the radiation plan been approved by the locally nuclear agency?
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Has the main door installed as the physicist specification guidelines?
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Is a cylinder of 99.9% SF6 available?
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State any political issues or problems to be avoided.
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State any special communication arrangements with regard to the ordering and delivery of service parts from Elekta to the hospital during the installation.
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Is the site approved to start the installation?
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Date:
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signed-off by: