-------------------------SYSTEM

DATE~ ________ ~ ___ LASER HEAD S/N~~ ________ POWER SUPPLY S/N __ ~~ __ __

OUTPUT POWER mW NOISE P-P % (60Hz-100KHz) -------- -----------

------------------------CDRH COMPLIANCE CHECK----------------------------------------------

Dear Customer:

This checklist is evidence that your serial numbered laser has been audited by Omnichrome for the presence and proper functioning of CDRH required features. It is recommended that you review and retain this list.

ITEM

MASTER KEY SWITCH WITH KEY

KEY NOT REMOVABLE IN ON POSITION

ON-OFF ROTARY SWITCH

BEAM ATTENUATOR

APERTURE LABEL ON BEAM ATTENUATOR

WARNING LOGOTYPE

CERTIFICATION LABEL

IDENTIFICATION LABEL

PRESENCE VERIFIED

PROTECTIVE HOUSING INTEGRITY­VISUAL CHECK

REMOTE CONTROL CONNECTOR (INCL. JUMPER)

EMISSION INDICATOR

TECH.

Q.A. MGR. ____ ~~~4A~~~~----------

PROPER OPERATION VERIFIED

9/27/85