Functional Test of Lighting Circuitry and illuminance Measurement (Sheet ____ of ____ Sheets)

Human Health OT 1
Project: Room Name:
Ref No.: 2216 Light Type: LED panel and LED downlight

1. Function Test of Lighting Circuitry

Lighting Circuitry No Functional test (On /Off or Dimmer) Result (Pass /Fail)
1 Dimmer Pass

2 Dimmer Pass

3
4

2. Measurement of illuminance (lux)

Position illuminance (lux) Result (Pass /Fail)
1
2
3
4

3. Testing Instrument
Instrument brand: Name:
Model No.: S/N:

Customer Representative

Position: Signed:

Date: Name:

Medtech Representative

Engineer
Position: Signed:

May 18, 23 Cyrus Cheung

Date: Name:

Revision: 0