(c)
If no action is required, place an "X" or "√" in the "ok" column.
(d) If action is required, annotate the action needed in the "action-
needed" column.
(e) When the action has been taken, enter the date and your initials in
the "action-taken" column.
(10) Block 16, synchronizer operation. Refer to figure 2-9.
(a) Test and verify synchronizer operation.
(b) If no action is required, place an "X" or "√" in the "ok" column.
(c)
If action is required, annotate the action needed in the "action-
needed" column.
(d) When the action has been taken, enter the date and your initials in
the "action-taken" column.
(11) Block 17, other features (specify). Refer to figure 2-9.
(a) Specify, inspect, and verify the operation test of any optional
features not listed on the DA Form 5624-R.
(b) If no action is required, place an "X" or "√" in the "ok" column.
(c)
If action is required, annotate the action needed in the "action-
needed" column.
(d) When the action has been taken, enter the date and your initials in
the "action-taken" column.
(12) Certification. Refer to figure 2-2.
(a) Certify after energy output levels have been verified and inspection
indicates that no action is needed.
(b) Complete the DA Form 5623, Defibrillator Energy Output
Certification, and attach it to the defibrillator (paragraph 2-3). Enter an "X" in the "DA
Form 5623 replaced" block. Some older forms may refer to DD Forms 1942 and 1944
in this block.
NOTE:
You will use the information from DA Form 5624-R to complete the DA Form
5623.
MD0358
2-14