K-Patents PR-23 for K-Patents Appendix - Manual (Page 42)

Document/Revision No. IM-GB-PR23-VACCINES: Rev. 1.01 Effective: November 1, 2013
42
Appendix to the Instructions Manual PR-23
6.12 Installation Qualification Summary Report
Successful completion of the preceding activities and checks indicates that this instrument
has been satisfactorily delivered and installed. This instrument has passed the Installation
Qualification and may now be submitted for Operational Qualification.
IQ completed by
Name:
Function:
Date:
Signature:
Signature:
IQ deviations approved by
Name:
Function:
Date:
Signature:
Signature:
IQ approved by
Name:
Function:
Date:
Signature:
Signature:
Comments (including discrepancies)