1nteracoustics

License certificate
The license number for your new
equipment is:

AUD 01FL8P3HCS9VBQ51ZP7 1WVK

to: •

,. . .Jf.•·:t:IOENSE
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3. ' . FdR ·PA~tlSTO, SN0959263

Order No. PO32307

ltem No. 8511306

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lnteracoust1cs
 Final lnspection Report
ID no.: Inspector lnitials: Date:
FI - 23624094 KBUT 2017-10-23
Device name: ltem no: Tracklng no.:
Cal listo 8511306 SN0959263

1) Product to be inspected according to generic labeling inspection instruction:

a: A c: A e: A g: N/A i: k:
b: A d: A f: A h: j: 1:

2) Documentation and items, according to packing list and/or order A

confirmation, to be present:

3) Test performance according to Test and Calibration Reports:

AII tests are performed and approved: A

AII test certificates are signed: A

4) Product to be intact (no scratches, bulges, missing buttons etc.): A

S) Product to be inspected according to product related inspection instruction:

a: A value: j: A value: s: value:

b: A value: k: N/A value: t: value:

c: A value: 1: A value: u: value:

d: A value: m: N/A value: v: value:

e: A value: n: N/A value: w: value:

f: A value: o: N/A value: x: value:

g: N/A value: p: N/A value: y: value:
h: A value: q: A value: z: value:
i: A value: r: N/A value: value:
ªª

Description ENG (national language is optional):

Decision: Approved
1EXM639-2016
1-

. cJád¿ r 1

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2017-10-23
Final inspection approved by: .. /l./f..<!.... . ... te, ...........................................
(Signature) (Date)

t•medial actions ENG (national language is optional): _

1
Remedia! actions completed by:
(lnltials) (Date)
Definitions:
A= Approved R= Rejected N/A = Not applicable "-" = Not inspected

QLE-FORM-3, rev.lrew.2 Page/Strona 1 of 1

 Audiometer Calibration Certificate
~ustomer lnformation Audlometer lnformatlon Paoe 1 of2
N/A Model: lnteracoustlcs Calllsto
Serial Number: SN0959263 Firmware: 1.1.16722.24790 lmoedance: 1OOhms
Trensducer Model S/N Left S/N Rloht
Headphones OD45 WT216343 M/T216347 <ID
Bone Oselllator Radloear B71 52883030 lnteracoust1cs
Calibration lnformation Mlc/Sensor Descrlotlon S/N ' MleCal Date
IACS-600 Audlometer Calibration System - Software Verslon 4.6.0.38 Headphone Left LD 2575 1777 April6,2017
Serial Number: 600-0411-2 Last Calibrated: Julv 17 2017 Headphone Rlght LD 2575 1732 April6,2017
Audiometer Calibration Date: October 23, 2017 05:05:21 PM Mastoid B&K4930 316260 October 6, 2017
Next Calibration Due: October 23, 2018 Pistonphone B&K4228 2512936 July 06, 2017
Calibrated by: DPP037
Technician: PGRO
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Sianature: -f'....,_,_~ o t
Reference Standards Couoler Descriotion S/N Tvoe
IAudiometer: ANSI S3.6 (2010) Headphone Left B&K4152 2986938 NBS-9A/IEC-60303/318-3
Headphones: ANSI S3.6 (201 O) Headphone Right B&K4152 2986939 NBS-9A/I EC-60303/318-3
Bona Oscillator: ANSI S3.6 (2010)
Speech: ANSI S3.6
Headohone Leve! Headnhone THD Headohone Narrow Headohone White Nolse
Test Test Target Ose1 Ose 1 Ose 1 Ose 1 Test Test Ose 1 Ose 1 Test Test Target Ose 1 Ose 1 Test Test Ose 1 Ose 1
Freo Level Level Left Hz Left Riaht Hz Rioht Freo Leve! Left Rioht Fren Level Leve! Left Riaht Freo Level Left Rioht
125 40 87.5 125.0 -O.O 125.0 -0.1 125 75 0.214 0.112 125 40 91.5 0.6 o.o
250 65 92.0 250.0 o.o 250.0 -O.O 250 90 0.107 0.043 250 60 91.0 O.O -0.1 250
500 75 88.0 500.1 -O.O 500.1 -O.O 500 110 0.274 0.106 500 70 87.0 0.1 0.1 500
750 80 86.5 750.0 -O.O 750.0 -O.O 750 110 0.142 0.072 750 75 86.5 0.3 0.1 750
1000 80 86.0 1000.0 -O.O 1000.0 -O.O 1000 110 0.142 0.081 1000 75 87.0 o.o -0.1 1000
1500 80 88.0 1500.0 0.1 1500.0 0.1 1500 110 0.122 0.180 1500 75 89.0 -0.1 0.2 1500
2000 80 88.0 2000.0 o.o 2000.0 o.o 2000 110 0.314 0.237 2000 75 89.0 0.1 -0.1 2000
3000 80 88.0 3000.0 o.o 3000.0 o.o 3000 110 0.271 0.279 3000 75 89.0 -0.1 0.1 3000
4000 80 89.0 3999.9 o.o 3999.9 o.o 4000 110 0.422 0.492 4000 75 89.0 -0.1 0.1 4000
6000 75 95.5 5999.7 o.o 5999.7 o.o 6000 90 0.018 0.006 6000 70 95.5 -0.1 o.o 6000
8000 75 87.0 7999.6 -O.O 7999.6 -O.O 8000 90 0.012 0.008 8000 70 87.0 -0.2 -O.O Total 90 o.o o.o
Headohone Sneech Noise Headohone Sneech Lvl Bona Level BoneTHD Bona Narrow
Test Test Ose 1 Ose 1 Test Test Ose 1 Ose 1 Test Test Target Ose 1 Ose 1 Test Test Ose 1 Test Test Target Ose 1
Slanal Leve! Left Rioht lnout Sianal Left Ri□ht Freo Leve! Leve! Hz Frea Leve! Freo Level Level
Soeech 65 -0.2 0.1 EXT 1 1000 -O.O -O.O 250 15 82.0 250.0 -O.O 250 20 1.906 250 10 81.0 0.1
Eauiv FF 65 -0.5 0.1 EXT2 1000 500 20 78.0 500.1 -O.O 500 50 1.159 500 20 82.0 -O.O
Non Lin 65 -0.2 -O.O MIC 1000 750 30 78.5 750.0 -O.O 750 50 1.740 750 25 78.5 0.3
ILTASS 65 -0.1 -0.1 EXT1 Eouiv FF o.o -O.O 1000 40 82.5 1000.0 -O.O 1000 60 0.700 1000 30 78.5 o.o
TENoise 65 -0.1 0.1 EXT2 Eauiv FF 1500 45 81.5 1500.0 O.O 1500 60 0.141 1500 40 82.5 -0.4
MIC Eouiv FF 2000 50 81.0 2000.0 -O.O 2000 60 0.332 2000 45 82.0 0.2
EXT 1 Non Lin -O.O o.o 3000 50 80.0 3000.0 o.o 3000 60 0.197 3000 45 81.0 -0.3
EXT2 Non Lin 4000 45 80.5 3999.9 0.1 4000 60 0.214 4000 40 80.5 0.1
MIC Non Lin 6000 40 80.0 5999.7 o.o 6000 50 0.232 6000 35 80.0 0.1
8000 40 80.0 7999.6 -O.O 8000 40 0.012 8000 35 80.0 -0.1
lnteracoustics Callista S/N: SN0959263 Paoe 2 of 2
Bone Whlte Noise Bone Soeech Nolse Bone Soeeeh Lvl
Test Test Ose 1 Test Test Ose 1 Test Test Ose 1
Frea Level Slanal Level lnout Slonal
250 Soeech 25 -0.5 EXT 1 1000 -O.O
500 ILTASS 25 0.2 EXT2 1000
750 MIC 1000
1000
1500
2000
3000
4000
6000
Total 40 -0.1
Electrical
Test Test Oscillator 1 Left Osdllator 1 Rlaht
Freo Level Frea THD Off Fall Rise Over Cross L Cross R Freo THD Off Fall Rise Over Cross L Cross R
125 75 125.0 0.114 -122.1 24.1 24.1 0.00 -88.9 -88.8 125.0 0.114 -117.4 24.1 32.2 0.00 -89.0 -88.8
250 90 250.0 0.019 -112.0 24.2 24.2 0.01 -89.2 -89.0 250.0 0.018 -112.7 28.3 24.2 0.02 -89.2 -89.1
500 110 500.1 0.018 -114.7 24.5 24.5 0.14 -90.3 -89.8 500.1 0.017 -115.6 26.5 24.5 0.05 -90.3 -89.9
750 110 750.0 0.010 -113.6 24.5 24.5 0.15 -92.5 -90.4 750.0 0.010 -114.8 24.5 24.5 0.16 -92.5 -90.3
1000 110 1000.0 0.006 -116.8 25.0 23.9 0.21 -93.7 -90.3 1000.0 0.007 -113.0 23.9 26.0 0.13 -93.7 -90.2
1500 110 1500.0 0.012 -116.1 23.8 23.8 0.21 -90.8 -89.0 1500.0 0.010 -114.9 24.5 25.2 0.20 -90.8 -88.9
2000 110 2000.0 0.014 -117.1 25.4 24.8 0.38 -89.1 -87.7 2000.0 0.009 -116.1 23.8 25.9 0.29 -89.2 -87.7
3000 110 3000.0 0.006 -113.5 22.8 27.6 0.54 -87.2 -85.8 3000.0 0.005 -112.9 24.0 28.0 0.55 -87.1 -85.9
4000 110 3999.9 0.010 -114.0 24.8 25.2 0.31 -86.4 -84.9 3999.9 0.010 -112.8 24.4 26.0 0.26 -86.6 -84.8
6000 90 5999.7 0.008 -104.6 24.8 25.2 0.20 -85.0 -82.8 5999.7 0.003 -102.9 24.0 24.8 0.21 -85.3 -82.9
8000 90 7999.6 0.006 -111.6 24.4 25.2 0.24 -84.8 -81.9 7999.6 0.006 -111.2 24.8 24.8 0.27 -84.7 -82.0
Linearitv (EL) Warble Rate Pulse Width
Test Ose 1 Ose 1 Test Ose 1 Ose 1 Test Ose 1 Ose 1 Test Ose 1 Ose 1
Leve! Left Rioht Leve! Left Rioht Level Left Rioht Freo Left Rloht
110 -0.39 -0.36 70 0.00 -0.00 30 0.09 0.16 125 5.02 5.02 Ose 1 Left 487.0
105 -0.35 -0.36 65 0.01 0.04 25 0.16 0.26 250 5.01 5.02
100 -0.34 -0.32 60 0.01 0.05 20 0.22 0.18 500 5.01 5.02
95 -0.08 -0.05 55 0.04 0.09 15 0.12 0.18 750 5.02 5.04
90 -0.08 -0.04 50 0.03 0.09 10 0.22 0.22 1000 5.02 5.02
85 -0.04 -0.04 45 0.02 0.10 +/-1.20 +/-1.20 1500 5.00 5.03
80 -0.03 0.00 40 0.10 0.13 2000 5.00 5.02
75 -0.04 -0.01 35 0.12 0.16 3000 5.02 5.01
4000 5.01 5.02
6000 5.02 5.02
8000 5.02 5.02