Lot 2-B-1, Phase 1B,

First Philippine Industrial Park,

JMS Healthcare PHL, Inc. Special Economic Zone,
Tanauan City, Batangas, Philippines

INSTALLATION QUALIFICATION CHECK LIST

Prepared by Checked by Approved by

Machine Name: __________________________________________________

CHECKING
CHECK ITEMS REQUIREMENTS RESULT DATE REMARKS
METHOD
1. Confirms if machine/equipment shows Yes  No 
no visual damages and/or defects. Visual check
N/A 
2. Confirm if machine/equipment
Yes  No 
accessories and parts corresponds with Visual check
N/A 
Parts Lists.
3. Confirm if machine/equipment
accessories and parts has been installed Yes  No 
Visual check
in conformance with design requirements N/A 
and specifications.
4. Confirm if machine/equipment
mechanical parts and components has Yes  No 
Visual check
been labeled correctly according to N/A 
design requirements and specifications.
5. Confirm if mechanical devices with
EQUIPMENT industrial specifications, settings and Yes  No 
PARTS Visual check
parameters are preset, checked and N/A 
documented.
6. Confirm if electrical elements, parts and
Yes  No 
components are installed according to Visual check
N/A 
design requirements and specifications.
7. Confirm if labelling is correct and
Yes  No 
complete for all electrical loop elements Visual check
N/A 
for example wiring and data cables.
8. Confirm if electrical and electronic
devices with industrial specifications, Yes  No 
Visual check
settings and parameters are preset, N/A 
checked and documented.
9. Confirm if hardware interlocks and Visual check
Yes  No 
electrical safety interlocks are checked through actual
N/A 
and functioning properly. operation
1. Confirm if machine/equipment was Visual check
Yes  No 
power up without visual through actual
N/A 
abnormalities/defects. operation
2. Confirm if machine/equipment was Check through Yes  No 
power up without abnormal sound/noise. actual operation N/A 

3. Confirm if machine/equipment was Check through Yes  No 

EQUIPMENT power up without abnormal vibrations. actual operation N/A 
FUNCTIONS 4. Confirm if machine/equipment system
Visual check
and every operational modules Yes  No 
through actual
functioning according to design N/A 
operation
requirements and specifications.
5. Confirm if all machine/equipment parts,
Visual check
components and devices are functioning Yes  No 
through actual
according to design requirements and N/A 
operation
specifications.
EQUIPMENT 1. Confirm if the entire machine/equipment Visual check Yes  No 
FINAL system is operating according to design N/A 
requirements and checked.

INF-VPIQ-016-19-001
 Lot 2-B-1, Phase 1B,
First Philippine Industrial Park,
JMS Healthcare PHL, Inc. Special Economic Zone,
Tanauan City, Batangas, Philippines

2. Confirm if the machine/equipment was Yes  No 

calibrated. State the ID No. of Visual check
N/A 
equipment.
Calibration
No. ID No. Equipment Description Calibration Date
Due Date

CHECK

3. Confirm if machine/equipment is
Yes  No 
installed successfully and IQ Stage is Visual check
N/A 
completed.
1. Confirm if the environment temperature
UTILITY / and humidity are within the standard Yes  No 
Visual check
FACILITY specification. N/A 

INF-VPIQ-016-19-001