Sterilizer Test Record (VACUUM / TYPE B) Sterilizer serial number____________________ Location__________________ Daily tests week commencing __________ – Automatic Control Test (ACT) Steam Cycle Penetration Reservoir Checks Pass/Fail Cycle Values during hold period Day Signature Pass/Fail number M = manual Test drained** time Temp. Pressure Hold time min:sec test* Pass/Fail Deg C Bar min:sec Mon Tue Wed Thu Fri Sat Daily tests week commencing __________ – Automatic Control Test (ACT) Steam Cycle Penetration Reservoir Checks Pass/Fail Cycle Values during hold period Day Signature Pass/Fail number M = manual Test drained** time Temp. Pressure Hold time min:sec test* Pass/Fail Deg C Bar min:sec Mon Tue Wed Thu Fri Sat *Note it is recommended that at least once a week the ACT is done manually by directly observing the – sterilization temperature and pressure and measuring the hold time with a stopwatch. Note this on the test sheet by placing (M) after Pass/Fail on the day it is conducted. ** The reservoir is drained at the end of each day and left to dry overnight. § Weekly safety checks & weekly tests Safety Checks Pass/Fail Tests Pass/Fail Date Automatic Cycle Overall Door Door Automatic Signature Door [Other Automatic Air Detect’n week number Pass/Fail pressure closed Air commen seal specify] Control System -ncing interlock interlock Leakage Function § Consult Manufacturer’s Instructions for specific safety checks and tests relating to this machine. Next maintenance by Test Person (Sterilizers) due ___________________ Yearly maintenance and Revalidation by Test Person (Sterilizers) due ___________________ Pressure Vessel Inspection due ___________________
Sterilizer Test Record (VACUUM / TYPE B) Sterilizer serial number____________________ Location__________________ Daily tests – week commencing __________ Day Checks Pass/Fail Cycle number Automatic Control Test (ACT) Steam Penetration Test Pass/Fail Signature Reservoir drained** Values during hold period Cycle time min:sec Pass/Fail M = manual test* Temp. Deg C Pressure Bar Hold time min:sec Mon Tue Wed Thu Fri Sat Daily tests – week commencing __________ Day Checks Pass/Fail Cycle number Automatic Control Test (ACT) Steam Penetration Test Pass/Fail Signature Reservoir drained** Values during hold period Cycle time min:sec Pass/Fail M = manual test* Temp. Deg C Pressure Bar Hold time min:sec Mon Tue Wed Thu Fri Sat *Note – it is recommended that at least once a week the ACT is done manually by directly observing the sterilization temperature and pressure and measuring the hold time with a stopwatch. Note this on the test sheet by placing (M) after Pass/Fail on the day it is conducted. ** The reservoir is drained at the end of each day and left to dry overnight. Weekly safety checks & weekly tests § Date week commen -ncing Cycle number Safety Checks Pass/Fail Tests Pass/Fail Signature Overall Pass/Fail Door seal Door pressure interlock Door closed interlock [Other specify] Automatic Control Automatic Air Leakage Automatic Air Detect’n System Function § Consult Manufacturer’s Instructions for specific safety checks and tests relating to this machine. Next maintenance by Test Person (Sterilizers) due ___________________ Yearly maintenance and Revalidation by Test Person (Sterilizers) due ___________________ Pressure Vessel Inspection due ___________________