Fluke Biomedical 07-644 - Manual (Page 9)

Operation
Operation
2
2-3
Sample Grid Alignment QC Form
Room 103 Unit GE II
Grid
Tested
Radiographic Table
Grid Ratio 12:1
Line
No.
103 lines/in.
Focal
Distance
40”
SID 40” kVp 60 mA 5 mAs Time N/A
Measured Optical Density
: : Reference Location
(3 small marking holes toward
the front of the table)
0
Date 2 1
Center
1 2 Comments
Checker’s
Initials
1-15-94 .61 1.11 1.47 1.14 .65 Alignment OK MR
5-18-94 .31 .73 1.17 1.47 1.05 Check Alignment MR
5-19-94 .63 1.13 1.51 1.15 .66 OK After Service MR