Title Page
-
Document No.
-
Audit Title
-
Client / Site
-
Conducted on
-
Prepared by
-
Location
-
Personnel
Admin
-
In accordance with current Varian "Standard Terms and Conditions of Sale" RAD1652, the following are minimum facility requirements to be accomplished before the machine can be released for shipment. Requests for any exceptions should referred to your Varian Installation Project Manager. the Customer is responsible for meeting these minimum requirements prior to the scheduled day of this inspection. If delays in facility completion postpone Varian's Installation, the Customer shall reimburse Varian, at Varian's standard service rates, for any extra time and/or travel by Varian made necessary by the delay.
-
I have explained these requirements to the Customer on this date along with specific requirements list below.
-
Varian Representative:
-
Customer Representative:
-
Address same as Sales Order "Ship To"
-
Site Name:
-
Serial Number:
-
Site Address:
General Requirements
-
NOTE: The Customer is responsible to confirm, provide, and/or demonstrate to the Varian Installation Project Manager the following items meet or exceed minimum requirements set forth in Varian's Designer Desk Reference (DDR). The Varian work area is defined as the treatment room, control room, and ancillary areas wherein Varian equipment will be installed.
-
1. A&E Drawings reviewed by Varian Planning Department and a copy of the drawing review on file.
-
2. Customer has applied for or obtained all approvals or licenses, as required.
-
3. Building is dry and secure.
-
4. Customer affirms they have met Varian's HVAC requirements for the equipment to be installed.
-
5. Debris removal arranged for approximately 30 cu. yds. on day of delivery.
-
6. The area is isolated from the general construction area if construction continues elsewhere in the building. This area should be sealed to ensure that the construction dust particles from those adjoining areas do not enter the Varian work area through any means.
-
7. Varian personnel have access to the building for all purposes related to the equipment installation.
-
8. No trades allowed during equipment installation.
-
9. Walls, lighting, and ceilings are complete and/or operational. (Primer coat is required at a minimum on all walls.)
-
10. Casework is complete. (If not located in the rig path)
-
11. Flooring has been completed or prepared as previously agreed. (Note: Mark "Y" if existing floor is to be used.)
-
12. Restroom facilities and sink with running water available for installation personnel throughout the duration of the installation.
-
13. Customer confirms arrangements have been made for initial and ongoing debris removal by others.
-
14. For safety purposes, demonstrate a working telephone in the control room area.
-
Phone Number:
-
15. Network live and in-place.
-
16. High speed internet access installed/operational and login information provided for installation personnel.
-
Please provide login credentials or I.T. Contact name & number.
-
17. A clear rig path exists. -Measure all clearances from the unloading/staging area to the vault. Remove all construction materials and other obstacles from the rig path on the day of delivery and sweep the rig path clean.
-
18. Permanent power live and in place.
TREATMENT ROOM (VAULT)
-
19. Treatment room door and related hardware on-hand. Door should be hung only if it does not interfere with machine rigging.
-
20. Clear 4'-0" x 7'-0" (1225mm x 2125mm) opening at vault entry.
-
21. Varian base-frame correct levelness and height confirmed.
-
22. Correct number and size of conduits. All conduits must be clean and dry.
-
23. Primary power wiring and ground conductors meet Varian minimum requirements. <br> * 480V/80A, 3-phase + Ground (parity with power conductors, but no smaller than #6 GA)<br> * 208V/175A, 3-phase + Ground (parity with power conductors, but no smaller than #6 GA)<br> (Neutral not required for either power input)
-
24. Base-frame pull-box installed and formed in concrete.
-
25. Relay junction box installed and a conduit/route connected to:
-
Base-frame pull-box (new construction)
-
Modulator pull-box (renovations)
-
26. Main room lights connected to the relay junction box.
-
27. Two independent door interlock switches installed, tested, and connected to the relay junction box.
-
28. Facility emergency-off switches installed, tested, and connected to the relay junction box. Sensing resistors installed per A&E Drawings.
-
29. Warning lights installed, tested, and connected to the relay junction box.
-
30. Laser light wiring, receptacles, and mounting plates installed. Verify location, heights, and recess size.
-
31. Dual in-room monitors and directional microphone mount(s) installed, power ready, and dats cable conduit/box installed.
-
Ceiling mount
-
Wall mounts - T-rail mount for microphone required.
-
32. Optical camera location - ceiling mount and data cable conduit-box installed.
-
33. Closed circuit TV camera locations, power ready, and data cable conduit-box installed.
-
34. Live View Camera and directional microphone - data cable conduit-box installed.
-
35. Data cable conduit-box installed at PAVS wireless keyboard and mouse location. Power outlet installed near data outlet.
-
36. Data cable conduit-box installed at each audio speaker location.
-
37. Accessory pull-box installed and connected to in-room device locations.
-
38. Cooling water supply system is complete and available in service pit, valves below floor level, pressure tested, flushed clean, and terminated with threaded body, 1" NPT, female, shut-off valves.
-
39. Electrician will be available to pull Varian interconnect cables, and/or assist under direction, before or at rig-in. Qualified personnel available to connect utilities to Varian equipment as required.
-
Name & Contact Info:
-
40. Acceptable clearances to install and operate equipment.
CONTROL ROOM
-
41. Main disconnect breaker is complete, wired, and ready for service. (Note: GE VWB panel is recommended)
-
42. Console breaker is complete, wired, and ready for service. (N/A if using GE VWB panel).
-
43. Console power receptacle (IEC 60309) is complete, wired, and ready for service. Location is not more than 24" from Control Cabinet and not directly behind the cabinet.
-
44. Verify grounded electrical power receptacles available for control equipment components, per DDR requirements.
-
45. Casework is complete and ready. Cable routing access provided with 3" (72.6mm) grommets.
-
46. Ventilation sufficient for removal of heat from console equipment.
-
47. Control cabinets:
-
Stacked
-
Split
-
Side-by-side
-
48. Arrangements have been made to have the cabinet positioning bracket(s) installed at time of rig.
OTHER
-
49. Power Conditioning Unit I stalked and ready for service, if applicable.
-
50. Chiller Unit installed and ready for service, if applicable.
-
51. Varian installation cables on site. ( Not Applicable for most sites outside North America)
-
Provide due date:
-
52. MICAP survey has been completed and submitted.
-
53. Customer confirms they will supply 2 boxes of localization X-Ray Film and wet processor or Radio Chromic Dry Film for Varian installation.
-
54. Secure, environmentally controlled, storage area (located near Varian work area) available for approximately 400 sq. ft. Of material. Varian installation personnel will require continuous access.
-
Please indicate location / room number:
-
55. Qualified physicist available for preliminary radiation survey. Coordinate timing with installation personnel.
-
Record Physicist's name and number:
-
56. Qualified physicist and dosimeter calibration equipment available for acceptance testing. Coordinate timing with installation personnel.
-
Record Physicist's name and number:
-
Additional information: (proceed each comment with respective item number from list above)
-
General comments:
Report Synopsis
-
Inspection Results:
-
Varian Representative:
-
Customer Representative:
