IECEE OD-2020-F7:2021 © IEC 2021 Ed.2.0 EMC TRF Template 2021-06-03

Disclaimer: This document is controlled and has been released electronically. Only the version on the IECEE Website is the current document version

Test Report issued under the responsibility of:

TEST REPORT Electromagnetic Compatibility

Report Number. .............................. : Click or tap here to enter text

Date of issue ................................... : Click or tap to enter a date.

Total number of pages ................... : 83 Name of Testing Laboratory preparing the Report ...................... :

Applicant’s name ........................... :

Address ........................................... :

Test specification:

TRF template used: IECEE OD-2020-F7:2020; ed. 2

Standards ....................................... : According to OD-2020, Clause 3.3

Test procedure ............................... : CB Scheme

Test Report Form No. .................... : According to OD -2020, Clause 3.3

Test Report Form(s) Originator .... : Name of Originator

Master TRF ...................................... : Dated YYYY-MM-DD (according to 3.3.4)

Copyright © 2021 IEC System of Conformity Assessment Schemes for Electrotechnical Equipment and Components (IECEE System). All rights reserved. This publication may be reproduced in whole or in part for non-commercial purposes as long as the IECEE is acknowledged as copyright owner and source of the material. IECEE takes no responsibility for and will not assume liability for damages resulting from the reader's interpretation of the reproduced material due to its placement and context. If this Test Report Form is used by non-IECEE members, the IECEE/IEC logo and the reference to the CB Scheme procedure shall be removed. This report is not valid as a CB Test Report unless signed by an approved CB Testing Laboratory and appended to a CB Test Certificate issued by an NCB in accordance with IECEE 02.

General disclaimer:

The test results presented in this report relate only to the object tested. This report shall not be reproduced, except in full, without the written approval of the Issuing NCB. The authenticity of this Test Report and its contents can be verified by contacting the NCB, responsible for this Test Report.

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Test item description ..................... : Click or tap here to enter text

Trademark or brand name ............. : Click or tap here to enter text

Manufacturer................................... : Click or tap here to enter text

Model/Type reference(s) ................ : Click or tap here to enter text

Ratings ............................................ : Click or tap here to enter text

Responsible Testing Laboratory (as applicable), testing procedure and testing location(s):

CB Testing Laboratory:

Testing location/ address ............................. :

Tested by (name, function, signature) ........ :

Approved by (name, function, signature) ... :

Testing procedure: CTF Stage 1:

Testing location/ address ............................. :

Tested by (name, function, signature) ........ :

Approved by (name, function, signature) ... :

Testing procedure: CTF Stage 2:

Testing location/ address ............................. :

Tested by (name + signature) ...................... :

Witnessed by (name, function, signature) .. :

Approved by (name, function, signature) ... :

Testing procedure: CTF Stage 3:

Testing procedure: CTF Stage 4:

Testing location/ address ............................. :

Tested by (name, function, signature) ........ :

Witnessed by (name, function, signature) .. :

Approved by (name, function, signature) ... :

Supervised by (name, function, signature) :

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List of Attachments (including a total number of pages in each attachment): Example: Attachments for national differences

Summary of testing Tests performed (name of test and test clause):

Testing location:

Summary of compliance with National Differences Country code National differences standard

Ex: EU group differences Ex: EN 61000-6-1:xxxx Ex: EU group differences Ex: EN 61000-6-4:xxxx Ex: CA Ex: CSA xxxxx

Summary of compliance with standards not part of the IECEE CB scheme Test procedure Standard List the test procedure of the covered standard

List only standards which are not covered by the CB test procedure and are not national difference standards to standards covered under the CB test procedure.

Ex: ILAC accreditation Ex: ETSI EN 301 489-1:xxxx

Use of uncertainty of measurement for decisions on conformity (decision rule) :

No decision rule is specified by the IEC standard, when comparing the measurement result with the applicable limit according to the specification in that standard. The decisions on conformity are made without applying the measurement uncertainty (“simple acceptance” decision rule, previously known as “accuracy method”).

Other:… (to be specified, for example when required by the standard or client). Information on uncertainty of measurement: The uncertainties of measurement are calculated by the laboratory based on application of criteria given by OD-5014 for test equipment and application of test methods, decision sheets and operational procedures of IECEE. IEC Guide 115 provides guidance on the application of measurement uncertainty principles and applying the decision rule when reporting test results within IECEE scheme, noting that the reporting of the measurement uncertainty for measurements is not necessary unless required by the test standard or customer.

Calculations leading to the reported values are on file with the NCB and testing laboratory that conducted the testing.

Commented [MT1]: Removed as per CMC Decision 45/2021

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Copy of marking plate ............... : The artwork below may be only a draft. The use of certification marks on a product must be authorized by the respective NCBs that own these marks.

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Possible test case verdicts: - test case does not apply to the test item . : N/A (Not Applicable)

- test item does meet the requirement ........ : P (Pass)

- test item does not meet the requirement . : F (Fail)

Date of receipt of test item ........................... : Click or tap to enter a date.

Date (s) of performance of tests .................. : Click or tap to enter a date. to Click or tap to enter a date.

General remarks:

"(See Enclosure #)" refers to additional information appended to the report. "(See appended table)" refers to a table appended to the report. Throughout this report a comma / point is used as the decimal separator. Note: Throughout this TRF, numerical data taken from IEC standards are using a comma as the decimal separator. Throughout this report, the term “Test item” is used over terms such as Test object, EUT or DUT.

Manufacturer’s Declaration per sub-clause 4.2.5 of IECEE 02:

The application for obtaining a CB Test Certificate includes more than one factory location and a declaration from the Manufacturer stating that the sample(s) submitted for evaluation is (are) representative of the products from each factory has been provided .................. :

Yes Not applicable When differences exist; they shall be identified in the General product information section.

Name and address of factory (ies) .............. :

General product information (GPI) and other remarks: Green text is provided as help for the TRF Originator and shall be deleted by the TRF Originator before a TRF is published. Red text is provided as help for the TRF User. The TRF User is both of the following: a. The laboratory preparing the TRF for its own use, applying company name, test specifics and similar. b. The report author (“Tested by”) or the report responsible (“Approved by”). Red text shall be either deleted or converted to regular Arial 10 or deleted before a report is issued. Examples of information to be entered in this section: 1. General description of the test item or the system of test items covered by this report if relevant. This could be intended use or how the test item / system works together with other products or similar descriptions, if judged relevant for the reader of this report or for the compliance of the test items in this report. 2. History of Test Report changes (Amendments, Corrections, Technical Modifications); Example: The original Test Report Ref. No. TR-12345a, dated 2015 February 8 was modified on June 22, 2015 to include the following changes and/or additions, which were considered technical modifications:… Note: Test items specifics including product family engineering statements are covered in chapter 1, not in this section.

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Table of Contents:

1 General description of test item ....................................................................................................... 7 1.1 Photo(s) of the test item ...................................................................................................... 7 1.2 Test item(s) ......................................................................................................................... 8 1.3 Port(s).................................................................................................................................. 8 1.6 Operating mode(s) ............................................................................................................ 10 1.7 Auxiliary equipment ........................................................................................................... 10 1.8 Documents as provided by the applicant .......................................................................... 11 1.9 Modifications to the test item during testing ...................................................................... 11 1.10 Description of test item specific for IEC xxxx .................................................................... 11

2 Verdict summary section ................................................................................................................ 12

3 Test conditions ............................................................................................................................... 14 3.1 Performance criteria for immunity tests ............................................................................ 14 3.2 Specific test conditions for IEC xxxx ................................................................................. 14 3.3 Test setups ........................................................................................................................ 15

4 Emission ......................................................................................................................................... 16 4.1 << Disturbance voltage / current >> .................................................................................. 17 4.2 << Discontinuous disturbances (clicks) >> ....................................................................... 20 4.3 << Disturbance power >> .................................................................................................. 23 4.4 << Disturbance field strength / Magnetic field >> ............................................................. 25 4.5 << Disturbance field strength / Electric field >> ................................................................ 27 4.6 IEC 61000-3-2 Limits for harmonic current emissions ...................................................... 29 4.7 IEC 61000-3-12 Limits for harmonic current emissions, public ........................................ 31 4.8 << IEC 61000-3-3 / IEC 61000-3-11 >> AC Mains Voltage fluctuation and flicker ........... 33

5 Immunity ......................................................................................................................................... 35 5.1 IEC 61000-4-2 << Electrostatic discharge immunity test (ESD) >> .................................. 36 5.2 IEC 61000-4-3 << Radiated, RF, electromagnetic field immunity test >> ........................ 39 5.3 IEC 61000-4-4 << Electrical fast transients / burst immunity test >> ................................ 43 5.4 IEC 61000-4-5 << Surge immunity test >> ....................................................................... 45 5.5 IEC 61000-4-6 << Immunity to conducted dist’s, induced by RF fields >> ....................... 47 5.6 IEC 61000-4-8 << Power frequency magnetic field immunity test >> .............................. 49 5.7 IEC 61000-4-11 << Voltage dips, short int’s and variations immunity test >> .................. 51 5.8 IEC 61000-4-34 << Voltage dips, short int’s and variations, +16 A per phase >> ............ 53 5.9 IEC 61000-4-29 << Voltage dips, short int’s and variations, d.c. input power >> ............. 55 5.10 IEC 61000-4-13 << Harmonics and interharmonics at a.c. power port >> ....................... 57 5.11 IEC 61000-4-16 << Conducted, common mode disturbances 0 Hz to 150 kHz >> ......... 60 5.12 IEC 61000-4-17 << Ripple on d.c. input power port >> .................................................... 63 5.13 IEC 61000-4-18 << Damped oscillatory wave >> ............................................................. 65 5.14 IEC 61000-4-39 << Radiated fields in close proximity >> ................................................. 68 5.15 << IEC 60601-1-2 Accompanying documents >> ............................................................. 73

6 Measurement instrumentation uncertainties .................................................................................. 82

7 List of test equipment ..................................................................................................................... 83

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1 General description of test item Note: The information in this section has been provided by the applicant. Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once. 1.1 Photo(s) of the test item

Photo 1.1.1 ................................... : Test item 1 front

Photo 1.1.2 ................................... : Test item 1 back

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1.2 Test item(s) Include all modules, variants and configuration parts which are to be considered test items. No. Test item name Unique identification / type / description Extent of test 1 Product variant A SN:123 / full function version Tested in full 2 Product variant B SN:456 / limited functionality Selected tests applied 3 Product variant C SN:566 / lower configured variant Not tested 4 Monitor SN:789 Tested in full 5 6 7 8

Engineering statement for untested variants / product family:

Click or tap here to enter text Advice to the TRF user: If not all test items have been tested in full (see above in column “Extent of test”), a rationale for the test program shall be made here or in a referenced document. State the originator of the engineering statement. Examples: 1. Assessed by the applicant: Test items A, B and C are parts of a product family. The highest configured variant (A) is tested in full, variant B was subjected to only radiated emission and immunity verification tests, variant C is a lower configured variant and assessed not to have higher emission levels or lower immunity than variant A. 2. New models have been added and only selected tests have been repeated, since they differ only from the original models by plastic housing variations, which is not considered relevant for EMC performance. Supplementary information: Click or tap here to enter text

1.3 Port(s)

No. Port Name Type Cable Specified

length in m Attached

during test Shielded

1 Enclosure Enclosure - - - 2 Mains power AC Mains - 3 Temp sensor A Signal 10 4 LAN Wired network +30 5 Aux out DC Output 2 6 7 8 9

10

Supplementary information: Click or tap here to enter text

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1.4 Power rating(s)

Power supply type ............ : AC, 1 phase

AC, 2 phases

AC, 3 phases

Neutral

Protective Earth

DC

Battery, not rechargeable in the device

Battery, rechargeable in the device

Rated voltage ................... : Click or tap here to enter text. (Example: 90 - 264 VAC or 24 VDC) Rated frequency ............... : Click or tap here to enter text. (Example: 50 – 60 Hz) Rated power ..................... : Click or tap here to enter text. (Example: 200 W)

1.5 Additional parameters

Protection class ................ : Click or tap here to enter text Example: Class I, Class II or Class III Clock frequencies ............. : Indicate here highest generated internal clock frequency as defined by

manufacturer / applicant or write “NIA” (no information available). (Example: 250 MHz)

Other parameters ............. : All parameters which seem necessary for testing can be documented here. Click or tap here to enter text or write “NIA” (no information available).

Software version .............. : Click or tap here to enter text or write “NIA” (no information available). Hardware version ............. : Click or tap here to enter text or write “NIA” (no information available). Dimensions (W x H x D) ... : Click or tap here to enter text cm Mounting position ............. : Table-top equipment

Wall/Ceiling mounted equipment

Floor standing equipment

Hand-held equipment

Other: Click or tap here to enter text

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1.6 Operating mode(s)

No. Abbreviation Detailed description of the operating mode Used for testing Emission Immunity

1 “Standby” Click or tap here to enter text. (Example: On running)

2 “Normal”

3

4

5

6

7

8

Supplementary information: Click or tap here to enter text 1.7 Auxiliary equipment Advice to the TRF User: Include accessories which are not to be considered test items. No. Aux Item Name Type and description Manufacturer

(if not the same) 1 “Mouse 1” Click or tap here to enter text (Example: Mouse) 2 Click or tap here to enter text (Example: External

power supply)

3 Click or tap here to enter text (Example: Monitor) 4 5 6 7 8

Supplementary information: Click or tap here to enter text

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1.8 Documents as provided by the applicant

No. Document ref. Type and description Doc date 1 “IFU 1234” Click or tap here to enter text (Example: Instructions For Use) Click or tap to

enter a date. 2 “RMF xyz” Click or tap here to enter text (Example: Risk Management File) Click or tap to

enter a date. 3 Click or tap here to enter text (Example: Test plan) Click or tap to

enter a date. 4 5 6 7 8

Supplementary information: Click or tap here to enter text 1.9 Modifications to the test item during testing

No modifications done during testing

Modifications done during testing (see details below) No. Description of modification (if any) Date of

modification 1

Click or tap to enter a date.

2

Click or tap to enter a date.

3

Click or tap to enter a date.

Supplementary information: Click or tap here to enter text 1.10 Description of test item specific for IEC xxxx Advice to the Originator of the TRF: Insert here the specific information needed for testing the relevant IEC xxxx, if needed. If not needed, then this clause may be deleted.

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2 Verdict summary section Rationale for verdicts, including N/A (Not Applicable), are listed on each test sheet. If applicable test was not performed then CB Test Certificate cannot be issued. Advice to TRF Originator: Use the following table format and content. In case of multiple standards, the table shall have separate rows for each test of each standard, separated by a headline containing the standard without year. “Requirement – Test case” shall be in the original wordings of the standard. “Basic standard” shall be listed including year and amendments. The last row of the table shall be “Supplementary information”.

IEC 61000-6-4 Table/ Clause

Requirement – Test case Basic standard Verdict

T 3.1 Radiated Emission – Enclosure 30 MHz – 1000 MHz (OATS or SAC)

CISPR 16-2-3:2016 P

T 3.2 Radiated Emission – Enclosure 30 MHz – 1000 MHz (TEM)

IEC 61000-4-20:2010 F

T 3.3 Radiated Emission – Enclosure 30 MHz – 1000 MHz (FAR)

CISPR 16-2-3:2016 N/A

T 3.4 Radiated Emission – Enclosure 1 GHz – 6 GHz (FSOATS)

CISPR 16-2-3:2016

T 4.1 Conducted emissions – Low voltage AC mains port

CISPR 16-2-1:2014/AMD1:2017

A.1.1 Conducted emissions – DC power port CISPR 16-2-1:2014/AMD1:2017 T 4.1 Continuous and discontinuous (clicks) CISPR 14-1:2016 T 5.1 Conducted emissions – Wired network port CISPR 32:2015

Supplementary information (e.g. detailed information to verdicts):

IEC 61000-3-2 or IEC 61000-3-12 Table/ Clause

Requirement – Test case Basic standard Verdict

7 AC-mains harmonic current emissions IEC 61000-3-2:2018 5 AC-mains harmonic current emissions IEC 61000-3-12:2011

Supplementary information (e.g. detailed information to verdicts):

IEC 61000-3-3 or IEC 61000-3-11 Table/ Clause

Requirement – Test case Basic standard Verdict

5 AC-mains voltage fluctuations and flicker IEC 61000-3-3:2013/AMD1:2017 5 AC-mains voltage fluctuations and flicker IEC 61000-3-11:2017

Supplementary information (e.g. detailed information to verdicts):

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IEC 61000-6-2 Table/ Clause

Requirement – Test case Basic standard Verdict

T 1.1 Power-frequency magnetic Fields IEC 61000-4-8:2009 T 1.2 Radio-frequency electromagnetic field

80 MHz – 1000 MHz IEC 61000-4-3:2006/ AMD1:2007/AMD2:2010

T 1.3 Radio-frequency electromagnetic field 1400 MHz – 6000 MHz

IEC 61000-4-3:2006/ AMD1:2007/AMD2:2010

T 1.4 Electrostatic Discharges IEC 61000-4-2:2008 T 2.1 Radio-frequency common modes (signal/control

port) IEC 61000-4-6:2013

T 2.2 Surges (signal/control port) IEC 61000-4-5:2014 T 2.3 Fast transients (signal/control port) IEC 61000-4-4:2012 T 3.1 Radio-frequency common modes (DC power

port) IEC 61000-4-6:2013

T 3.2 Surges (DC power port) IEC 61000-4-5:2014 T 3.3 Fast transients (DC power port) IEC 61000-4-4:2012 T 4.1 Radio-frequency common modes (AC power

port) IEC 61000-4-6:2013

T 4.2 Voltage dips (AC power port) IEC 61000-4-11:2004 IEC 61000-4-34:2005/AMD1:2009

T 4.3 Voltage interruptions (AC power port) IEC 61000-4-11:2004 IEC 61000-4-34:2005/AMD1:2009

T 4.4 Surges (AC power port) IEC 61000-4-5:2014 T 4.5 Fast transients (AC power port) IEC 61000-4-4:2012

Supplementary information (e.g. detailed information to verdicts):

EMC product standard number without date, e.g. IEC 61547 Table/ Clause

Requirement – Test case Basic standard Verdict

5.2 Electrostatic discharges IEC 61000-4-2:2008 5.3 Radiated, radio-frequency, electromagnetic field IEC 61000-4-3:2006 + A1 5.4 Power frequency magnetic fields IEC 61000-4-8:1993 + A1 5.5 Electrical fast transients IEC 61000-4-4:2004 5.6 Injected currents (radio frequency common

mode) IEC 61000-4-6:2008

5.7 Surges IEC 61000-4-5:2005 5.8 Voltage dips, short interruptions IEC 61000-4-11:2004 5.8 Voltage fluctuations IEC 61000-4-11:2004

Supplementary information (e.g. detailed information to verdicts):

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3 Test conditions 3.1 Performance criteria for immunity tests Advice to TRF Originator: Prepare this table as required by the product standard, delete rows for criteria not described in the standard. Column “Criteria” refers to the definitions in the standard.

Performance criteria details Criterion Description Monitoring

A Advice to TRF User: Enter manufacturer’s description of WHAT to monitor during test (Do not copy the general criterion from the standard). (Example: Motor speed is not allowed to differ more than 10 % form the selected value during and after test)

Advice to TRF User: Enter manufacturer’s description of HOW to monitor during test (visual inspection, bit error read-out…). (Example: Motor speed is shown at the test item display and visually monitored during test)

B

C

D

E

FS / DS

Basic safety Advice to TRF User This row is used by standards such as IEC 60601-1-2 and IEC 61326-2-6

Essential performance

Advice to TRF User This row is used by standards such as IEC 60601-1-2 and IEC 61326-2-6

Particular requirements

Advice to TRF User Add requirements from particular standards here (see IEC 60601-2-x / ISO 80601-2-x)

Other / user

Supplementary information: Click or tap here to enter text 3.2 Specific test conditions for IEC xxxx Advice to the TRF Originator: Insert the specific test conditions needed for testing according to the relevant IEC xxxxx, if needed. If not needed, then delete this clause.

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3.3 Test setups Figure 3.3.1 .................................. : Test setup 1

Figure 3.3.2 .................................. : Test setup 2

Advice to TRF User: Test setups can be described here and referenced at each test sheet. The number of test setups is decided by the laboratory. Test setups may be graphical illustrations such as block diagrams and/or descriptive text. If more (or less) illustrations / descriptions are needed, please copy (or delete) the tables. To update figure numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

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4 Emission Advice to TRF Originator: The Results section shall be designed in the following way: 1. Emission results 2. Harmonics/flicker 3. Immunity 4. Additional requirements (See documents test of IEC 60601-1-2 as example) Advice to the TRF Originator: All headings shall have the same wording as given in the products standard and in the summary section. Replace the headlines << xxxxxx >> by the original text of the product standard. Delete the “<<” and “>>” in the headings. Similar tests which are named differently in different standards can be separated by “/” in the test sheet heading. It is allowed to add extended test ranges / levels under the same heading by adding rows / tables / photos. Example: Radiated emission test from 1-6 GHz can be added under Radiated emission test after 30-1000 MHz. Note: In order eliminate risks of divergent test verdicts and in order to follow the general intention to avoid repetitions, verdicts are not listed at each individual test sheet but solely in the Verdict summary section. Advice to TRF Originator: Limits (e.g. “Applied limits”) are not listed in this section. The applicable limits are clearly defined in the product standards and it is not necessary to repeat them here. Only limit class or environment as selected by the applicant/manufacturer shall be indicated here. Typical content of the result section for disturbance voltage is given below. Rows below which are not applicable for the product standard shall be deleted by the TRF Originator. Additional content (rows) shall be added if required by the product standard. Information to the TRF user: In case the ambient noise level exceeds the required level, record the frequency / frequency range for that exceeding in the supplementary information. It is allowed to add extended test ranges / levels under the same heading by adding rows / tables / photos. Example: Radiated emission test from 1-6 GHz can be added under Radiated emission test after 30-1000 MHz. If a test is not applicable or not performed, delete the entire section except the heading and the three initial table rows. If a test has more than one set of results, a separate Test result section shall be made for each set of results, including the first three mandatory table rows of the result section specifying Test item no(s), Operating mode no(s) and Test setup no(s).

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4.1 << Disturbance voltage / current >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Applied limit class or environment: Class A according to applied standard

Class B according to applied standard

Other: Click or tap here to enter text

Test setup description ................. : Setup Type A (40 cm distance to vertical ground plane, 80 cm over ground plane)

Setup Type B (40 cm distance to horizontal ground plane)

Floor standing equipment setup (10 cm over ground plane)

Other: Click or tap here to enter text

Artificial hand applied

Supplementary test setup description ................................... :

Click or tap here to enter text

Test method applied .................... : Artificial mains network

Artificial mains network used as voltage probe

Voltage probe

CDN according to IEC 61000-4-6

Current probe and capacitive voltage probe (CVP)

Current probe

ISN

In situ CDN (150 Ohm and current probe)

Other: Click or tap here to enter text

Supplementary information ......... : Click or tap here to enter text

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Photo 4.1.1 ................................... : Disturbance voltage / current measurements

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

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Test results for disturbance voltage / current Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text

Advice to TRF Originator: Do not include other mandatory tables or diagram placeholders here. Advice to the TRF User: The laboratory decides the layout of the remaining parts of this results section, however with the following minimum requirements: Port which has been measured (Including measured terminal: L or N) Mains voltage and frequency at which the test has been done Used detectors Used IF BW and step size and / or Preamp Used measurement times per frequency for pre-scan (if applicable) and final measurement Diagram / spectrum of the disturbance voltage / current over the frequency range measured including the limits by following the requirements of the applicable product standard. Table of the final measurement values by following the requirements of the applicable product standard.

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4.2 << Discontinuous disturbances (clicks) >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............. : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test setup description ................. : Setup Type A (40 cm distance to vertical ground plane, 80 cm

over ground plane) Setup Type B (40 cm distance to horizontal ground plane)

Floor standing equipment setup (10 cm over ground plane)

Other: Click or tap here to enter text

Artificial hand applied

Supplementary test setup description ................................... :

Click or tap here to enter text

CDN applied ................................ : Artificial mains network

Artificial mains network used as voltage probe

Voltage probe

Other: Click or tap here to enter text

Applied method for discontinuous disturbances ............................... :

Click rate determined on base of switching operations

Click rate determined on base of clicks measurements

Other: Click or tap here to enter text

Exceptions from the click definition applied ......................... :

Individual switching operations (5.4.3.2)

Combination of disturbances in a time frame less than 600 ms (5.4.3.3)

Instantaneous switching (5.4.3.4)

Separation less than 200 ms (5.4.3.5)

Thermostatically controlled three-phase switches (5.4.3.6)

Superposition of clicks with continuous disturbance (5.4.3.7)

Other: Click or tap here to enter text

Supplementary information ......... : Click or tap here to enter text

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Photo 4.2.1 ................................... : Discontinuous disturbances (clicks)

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

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Test results for discontinuous disturbances (clicks) Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text

Advice to TRF Originator: Do not include other mandatory tables or diagram placeholders here. Advice to the TRF User: The laboratory decides the layout of the remaining parts of this results section, however with the following minimum requirements: Port which has been measured (Including measured terminal: L or N) Mains voltage and frequency at which the test has been done Results of the clicks evaluation: - observation time for each frequency - click rate for at least 150 kHz and 500 kHz - Input attenuator (if applied) - Number of short and long clicks (< 10 ms, 10 ms to 20 ms, 20 ms to 200 ms) - Number of Switching events (if applied) - Applied limit (dBµV) per frequency - Result of the upper quartile evaluation (if applied and if necessary)

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4.3 << Disturbance power >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............. : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test set up description ................ : Equipment on table 80 cm height

Equipment on support 10 cm height

Other:

Supplementary test setup description ................................... :

Click or tap here to enter text

Conditions for exemption from measurements above 300 MHz .. :

1) the disturbance power emission from the EUT is lower than the limits of Table 7 reduced by the values of Table 8;

2) the maximum clock frequency is less than 30 MHz

Supplementary information ......... : Click or tap here to enter text Photo 4.3.1 ................................... : Disturbance power

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

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Test results for disturbance power Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text

Advice to TRF Originator: Do not include other mandatory tables or diagram placeholders here. Advice to the TRF User: The laboratory decides the layout of the remaining parts of this results section, however with the following minimum requirements:

• Port which has been measured • Mains voltage and frequency at which the test has been done • Used detectors • Used measurement times per frequency for prescan (if applicable) and final measurement • Diagram / spectrum of the disturbance power over the frequency range measured including the limits

by following the requirements of the applicable product standard. • Table of the final measurement values by following the requirements of the applicable product

standard.

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4.4 << Disturbance field strength / Magnetic field >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............ : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Applied limit class ........................ : Class A according to applied standard

Class B according to applied standard

Other: Test set up description ................ : Equipment on a table 80 cm height

Equipment on the floor (isolated from ground plane)

Other: Supplementary test set up description ................................... :

Click or tap here to enter text

Test method applied .................... : Large loop antenna: Diameter x m

Small loop antenna with measurement distance [m]:

Other: Supplementary information ......... : Click or tap here to enter text

Photo 4.4.1 ................................... : Disturbance field strength / Magnetic field

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

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Test results for disturbance field strength / magnetic field Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text

Advice to TRF Originator: Do not include other mandatory tables or diagram placeholders here. Advice to the TRF User: The laboratory decides the layout of the remaining parts of this results section, however with the following minimum requirements:

• Mains voltage and frequency at which the test has been done • Used detectors • Used IF BW and step size and / or Preamp

Used measurement times per frequency for prescan and final measurement if applicable • Diagram of the disturbance field strength over the frequency range measured including the limits • Table of the final measurement values

Minimum content (columns) of the table: Frequency, Reading, Limit, Margin (Limit - reading), Polarization, turntable azimuth, antenna height

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4.5 << Disturbance field strength / Electric field >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............. : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Applied limit class ........................ : Class A according to applied standard

Class B according to applied standard

Other:

Test set up description ................ : Equipment on a table 80 cm height

Equipment on the floor (isolated from ground plane)

Other (e.g. height of pallet)::

Supplementary test set up description ................................... :

Click or tap here to enter text

Test method applied .................... : OATS or SAC with measurement distance [m]:

FAR with measurement distance [m]:

TEM waveguide

CDN(E) according to CISPR 15

Measurement above 1 GHz: Dimension of the line tangent to the EUT volume (beam width) ..... :

Not applicable Value of w:

Supplementary information ......... : Click or tap here to enter text Photo 4.5.1 ................................... : Disturbance field strength / Electric field

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

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Test results for disturbance field strength / electric field Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text

Advice to TRF Originator: Do not include other mandatory tables or diagram placeholders here. Advice to the TRF User: The laboratory decides the layout of the remaining parts of this results section, however with the following minimum requirements:

• Mains voltage and frequency at which the test has been done • Used detectors • Used IF BW and step size and / or Preamp

Used measurement times per frequency for pre-scan and final measurement if applicable • Diagram of the disturbance field strength over the frequency range measured including the limits • Table of the final measurement values

Minimum content (columns) of the table: Frequency, Reading, Limit, Margin (Limit - reading), Polarization, turntable azimuth, antenna height

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4.6 IEC 61000-3-2 Limits for harmonic current emissions

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............. : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Version of measurement instrument standard used IEC 61000-4-7 (Clause 7) ........... :

IEC 61000-4-7:2002 + A1:2008 (grouping of harmonics on)

IEC 61000-4-7:1991 (grouping of harmonics off)

Supplementary test set up description ................................... :

Click or tap here to enter text

Limit classification in accordance with the standard ......................... :

Class A

Class B

Class C with power > 25 W

Class C with power < 25 W Option a)

Class C with power < 25 W Option b)

Class D

Observation period ...................... : Description Period selected Tobs

Quasi stationary 2.5 min

Short cyclic Tobs ≥ 10 cycles =

Random Tobs =

Long cyclic Full program cycle or 2.5 min. with highest THC Tobs =

Control principle used in the sample ......................................... :

Click or tap here to enter text

Supplementary information ......... : Click or tap here to enter text

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Photo 4.6.1 ................................... : Limits for harmonic current emissions

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once. Test results for limits for harmonic current emissions Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text

Advice to TRF Originator: Do not include other mandatory tables or diagram placeholders here. Advice to the TRF User: The laboratory decides the layout of the remaining parts of this results section, however with the following minimum requirements:

• Mains voltage and frequency at which the test has been done • Active power or fundamental power and power factor • Power used for the calculation of power depending limits • Table of the final measurement values

Minimum content (columns) of the table: Harmonic order, Average values, limit

• Graphic representation of the wave shape if power < 25 W and limit C b) has been selected • If applicable, the test report shall indicate the input signal and settings of the television receiver.

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4.7 IEC 61000-3-12 Limits for harmonic current emissions, public

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............. : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test method ................................ : Direct measurement

Calculation by validated simulation

Version of measurement instrument standard used IEC 61000-4-7 (Clause 7) ........... :

IEC 61000-4-7:2002 + A1:2008 (grouping of harmonics on)

IEC 61000-4-7:1991 (grouping of harmonics off)

Supplementary test set up description ................................... :

Click or tap here to enter text

Minimum Rsce .............................. : Click or tap here to enter text Limit classification in accordance with the standard ......................... :

Non symmetrical equipment (Table 2)

Symmetrical 3-phase equipment (Table 3)

Symmetrical 3-phase equipment under special conditions (Table 4) Condition a)

Condition b)

Condition c)

Symmetrical 3-phase equipment under special conditions (Table 5) Condition d)

Condition e)

Condition f)

Observation period ...................... : Description Period selected Tobs

Quasi stationary

2.5 min

Short cyclic Tobs ≥ 10 cycles =

Random Tobs =

Long cyclic Full program cycle or 2.5 min. with highest THC Tobs =

Control principle used in the sample ......................................... :

Click or tap here to enter text

Supplementary information ......... : Click or tap here to enter text

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Photo 4.7.1 .................................. : Limits for harmonic current emissions, public

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once. Test results for limits for limits for harmonic current emissions, public Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text

Advice to TRF Originator: Do not include other mandatory tables or diagram placeholders here. Advice to the TRF User: The laboratory decides the layout of the remaining parts of this results section, however with the following minimum requirements:

• Mains voltage and frequency at which the test has been done • Power factor

Real power • Measurement Impedance of mains used during test • Reference current Iref • Table of the final measurement values

Minimum content (columns) of the table: Harmonic order, Average values, limit,

• Graphic representation of the waveshape if power < 25 W and limit C b) has been selected • For method: Simulation, insert documentation and results of the simulation used for determining

compliance.

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4.8 << IEC 61000-3-3 / IEC 61000-3-11 >> AC Mains Voltage fluctuation and flicker

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............. : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Applied standard ......................... : IEC 61000-3-3

IEC 61000-3-11

The test item deems to be compliant with the applied standard, on condition the manufacturer meets his obligations regarding EN 61000-3-11:2000, Section 4 a) and 4 b). The result is regarded as PASS if all information requested by EN 61000-3-11 is published in the user manual. Test impedance / maximum permissible system impedance

Maximum permissible system impedance (Cl. 6.3): ... Ω

Minimum permissible service current (6.4) >= 100 A / phase

Supplementary test set up description ................................... :

Click or tap here to enter text

Test method ................................ : 4.2.2 Flickermeter according IEC 61000-4-15

4.2.3 Simulation

4.2.4 Analytical method

4.2.5 Use of Pst = 1 curve

Observation time selected ........... : 10 Minutes

120 Minutes

24 times switching according to annex B of the standard

Limit for dmax applied ................... : 4 %

6 %

7 %

Supplementary information ......... : Click or tap here to enter text

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Photo 4.8.1 .................................. : AC Mains Voltage fluctuation and flicker

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once. Test results for limits for AC Mains voltage fluctuation and flicker Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text

Advice to TRF Originator: Do not include other mandatory tables or diagram placeholders here. Advice to the TRF User: The laboratory decides the layout of the remaining parts of this results section, however with the following minimum requirements:

• Mains voltage and frequency at which the test has been done • Impedance used for measurement (Zref = xx Ohms + j YY Ohms) • Table of the final measurement values

Minimum content (columns) of the table: pst, plt, dmax, dc, T(500 ms)

Minimum content (columns) of the table used for documenting the standard’s annex B measurement:

dmax for each of the 24 measurements final values of dmax for the average of 22 measurements

• Additionally, in case the IEC 61000-3-11 has been applied: Zmax (Maximum allowed system impedance for conditional connection)

Zsys for each measurement value (Plt, Pst, dc, dmax) • Graphic representation of the waveshape if power < 25 W and limit C b) has been selected

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5 Immunity Advice to TRF Originator: The sequence of the test sheets shall be identical to the sequence typically given in the product standard (if applicable) Information to the TRF user: The observation column is not intended to cover the complete observation In the observation field at the bottom of the result tables, add detailed descriptions of the observation including the duration for which the effect persists. Do not add verdicts and do not add performance criteria in the observation column. If there is the need of any special environmental conditions in which the tests need to be performed, record it in the supplementary information. If there is the need of any specific conditions necessary to enable the test to be performed, record it in the supplementary information. If a test is not applicable or not performed, delete the entire section except the heading and the three initial table rows. If a test has more than one set of results, a separate Test result section shall be made for each set of results, including the first three mandatory table rows of the result section specifying Test item no(s), Operating mode no(s) and Test setup no(s).

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5.1 IEC 61000-4-2 << Electrostatic discharge immunity test (ESD) >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............. : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Environmental conditions during the test

Temperature value Humidity value Atmospheric pressure value or interval

Click Click Click

Test set up ................................... : Table-top equipment

Floor standing equipment

Wall or ceiling mounted equipment (Treated as table top)

Supplementary test set up description ................................... :

Click or tap here to enter text

Size of horizontal coupling plate . : Click or tap here to enter text. (Example: 1.6 x 0.8 m) Number of discharges for each test point ...................................... :

10

Number of discharges ................. : Min. 10 per discharge location ESD generator to surface ............ : ESD-Generator is held perpendicular to the surface of the test

item ESD-Generator cannot be held perpendicular to the surface of

the test item. Description of the test condition: --

Performance criterion .................. : B Supplementary information ......... : Click or tap here to enter text

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Advice to TRF User: All points which have been tested can be documented using symbols identifying the test points and discharges being applied. The “narrow symbols” located in the cells below can easily be copied and moved directly on top of setup photo(s) indicating each tested point. The symbols can also be rotated or resized. If not used, then delete the symbols and cells below. Symbols identifying discharge applied ......................................... :

Contact discharge

Air discharge

Air discharge, discharge did not occur

Photo 5.1.1 .................................. : Electrostatic discharge immunity test (ESD)

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

Page 38 of 83 Report No. xxxxx

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Advice to TRF Originator: Adjust the results table to match the levels of the standard. Test results for electrostatic discharges (ESD) immunity test Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz)

Location of discharge Test level in kV Polarity Type Observations

Click or tap here to enter text. (Example: VCP) 4 P Conducted Click (Example:

None) Click or tap here to enter text.

(Example: HCP) 4 N Conducted Click (Example: Note 1)

Click or tap here to enter text. (Example: Display surface) 2, 4 and 8 P Air discharge Click (Example:

Note 2) Click or tap here to enter text. 2, 4 and 8 N Air discharge Click

Click Click Click Click

HCP = Horizontal coupling plate; VCP = Vertical coupling plate P= Positive; N= Negative Observations ............................... : Note 1:

Note 2: …

Bleeder equipment used? ........... : List test points and type of bleeder equipment Supplementary information ......... : Click or tap here to enter text

Advice to TRF User: If the test is performed at more than one test item and/or applied mains voltage / frequency, copy the table above. Advice to TRF user: Add here additional information (if applicable) for monitoring (e.g. recorded diagrams) or other information.

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5.2 IEC 61000-4-3 << Radiated, RF, electromagnetic field immunity test >> Advice to TRF Originator: The section is intended to be applied for IEC 61000-4-3. Similar tables might be created by the originators for IEC 61000-4-20 or IEC 61000-4-21. Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............ : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test setup .................................... : Equipment on the table (0,8 m height)

Equipment standing on floor (0,05 m to 0,15 m height) Other height: --

Deviations from arrangement of wiring ........................................... :

No deviations Yes (e.g. less than 1 m of cable exposed to the field or low-

inductive bundling not possible) Cable Rationale for deviation -- -- -- --

CMAD application ....................... : No CMAD has been applied CMAD’s have been applied

Cable with CMAD Remark -- -- -- -- -- --

Supplementary test set up description ................................... :

Click or tap here to enter text

Exposed side of EUT .................. : Front Left (viewed from front) Rear Right (view from front) Top Bottom

Rationale for not exposing a side : Click or tap here to enter text. (Example: Top and bottom are solid metal sheets, disturbances are not possible)

Size shape and height of the uniform area ................................ :

No. Size Shape Height 1 1,5 m x 1,5 m Rectangular 0,8 m 2 1 m x 1 m Rectangular 1,3 m

Partial illumination applied .......... : No partial illumination has been applied Partial illumination has been applied.

Description of the partial illumination: -- Test item fully placed inside UFA : Yes

No Description or delete this text. Example: Floor standing placed on floor because too heavy weight or physically too large to be raised. Or: Too large for the UFA (partial illumination applied

Tolerance range of the UFA up to 1 GHz .......................................... :

0 dB to + 6 dB 0 dB to + 10 dB

Actual tolerance: -- Distance Antenna to EUT ............ : Click or tap here to enter text. (Example: 3 m) Dwell time Click or tap here to enter text. (Example: 1 s) Step size in %.............................. : Click or tap here to enter text. (Example: 1 %) Performance criterion .................. : A Supplementary information ......... : Click or tap here to enter text

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Photo 5.2.1 .................................. : Radiated, RF, electromagnetic field immunity test

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

Page 41 of 83 Report No. xxxxx

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Advice to TRF Originator: Adjust the results table to match the ranges and levels of the standard. Test results for radiated, radio-frequency, electromagnetic field immunity test Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz)

Frequency range Test level in V/m

Polarization Modulation Observations

80 MHz – 1000 MHz 10 H / V AM 1 kHz 80 % Click (Example: None)

80 MHz – 2700 MHz 10 H / V AM 1 kHz 80 % Click (Example: Note 1)

80 MHz – 6000 MHz 3 H / V AM 1 kHz 80 % Click (Example: Note 2)

1400 MHz – 6 GHz 3 H / V AM 1 kHz 80 % Click 2700 MHz – 6 GHz 3 H / V AM 1 kHz 80 % Click

Observations ............................... : Note 1: Note 2: …

Supplementary information ......... : Click or tap here to enter text Advice to TRF User: If the test is performed at more than one test item and/or applied mains voltage / frequency, copy the table above. Advice to TRF user: Add here additional information (if applicable) for monitoring (e.g. recorded diagrams) or other information.

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Advice to TRF Originator: Adjust the results table to match the frequencies and levels of the standard. IMMUNITY to proximity fields from RF wireless communications equipment Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz) Dwell time Click or tap here to enter text. (Typically 3 s)

Frequency in MHz Test level in V/m Polarization Modulation Observations

385 27 H/V PM DC 50% Click (Example: None)

450 28 H/V PM DC 50% Click (Example: Note 1)

710 745 780

9 H/V PM DC 50% Click (Example: Note 2)

810 870 930

28 H/V PM DC 50% Click

1720 1845 1970

28 H/V PM DC 50% Click

2450 28 H/V PM DC 50% Click 5240 5500 5785

9 H/V PM DC 50% Click

Observations ............................... : Note 1: Note 2: …

Supplementary information: Click or tap here to enter text Advice to TRF User: If the test is performed at more than one test item and/or applied mains voltage / frequency, copy the table above.

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5.3 IEC 61000-4-4 << Electrical fast transients / burst immunity test >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............. : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test setup .................................... : Equipment on the table (0,1 ± 0,01) m above ground plane

Equipment standing on floor at (0,1 ± 0,05) m above ground plane

Artificial hand applied. Location see photo. Supplementary test set up description ................................... :

Click or tap here to enter text

Repetition frequency ................... : 5 kHz or 100 kHz Test time ...................................... : 1 min Performance criterion .................. : B Supplementary information ......... : Click or tap here to enter text

Photo 5.3.1 ................................... : Electrical fast transients / burst immunity test

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

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Advice to TRF Originator: Adjust the results table to match the levels of the standard. Test results for electrical fast transients / burst immunity test Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz)

Port name Test level in kV Polarity Coupling Observations

Click (Example: AC Power) 2 P CDN Click (Example: None)

Click (Example: AC Power) 2 N CDN Click (Example: Note 1)

Click (Example: Digital out 1) 1 P Clamp Click (Example: Note 2)

Click (Example: Digital out 1) 1 N Clamp Click Click Click Click Click

P= Positive; N= Negative Observations ............................... : Note 1:

Note 2: …

Supplementary information ......... : Click or tap here to enter text Advice to TRF User: If the test is performed at more than one test item and/or applied mains voltage / frequency, copy the table above. Advice to TRF User: Add here additional information (if applicable) for monitoring (e.g. recorded diagrams) or other information.

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5.4 IEC 61000-4-5 << Surge immunity test >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............ : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test set up description ................ : Click or tap here to enter text

(If higher current-rated CDN for DC/DC input converters was used, add it here.)

Repetition rate ............................. : Click or tap here to enter text. (Example: 30 sec.) Number of pulses for each coupling ....................................... :

5

Performance criterion .................. : B Supplementary information ......... : Click or tap here to enter text

Photo 5.4.1 .................................. : Surge immunity test

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

Page 46 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

Advice to TRF Originator: Adjust the results table to match the levels of the standard. Test results for surge immunity test Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz)

Port name Test level in kV

Polarity & phase in degrees

Coupling Observations

Click (Example: AC Power) 2 P: 0, 90, 180, 270

L1-N, CDN Click (Example: None)

Click (Example: AC Power) 2 P: 0, 90, 180, 270

L1-PE, CDN Click (Example: Note 1)

Click (Example: Digital out 1) 1 - L1-N, CDN UUI Click (Example: Note 2)

Click (Example: Digital out 1) 1 - L1-N, CDN SL Click Click Click Click Click Lower test levels ......................... : The lower test levels are tested also.

The lower test levels are not tested. P= Positive; N= Negative CDN from IEC 61000-4-5: CDN = CDN for AC or DC ports CDN UUI = network for unshielded unsymmetrical interconnection lines: line-to-line and line-to-ground coupling CDN USI = network for unshielded symmetrical interconnection lines: lines-to-ground coupling CDN USIC = network for unshielded symmetrical interconnection lines: lines-to-ground coupling via capacitors CDN SL = surges applied to shielded lines Observations ............................... : Note 1:

Note 2: …

Supplementary information ......... : Click or tap here to enter text Advice to TRF User: If the test is performed at more than one test item and/or applied mains voltage / frequency, copy the table above. Advice to TRF user: Add here additional information (if applicable) for monitoring (e.g. recorded diagrams) or other information.

Page 47 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

5.5 IEC 61000-4-6 << Immunity to conducted dist’s, induced by RF fields >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............ : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test setup .................................... : Equipment located (0,1 ± 0,05) m above ground plane

Elevated ground plane according to Annex F Artificial hand applied. Location see photo.

Supplementary test set up description ................................... :

Click or tap here to enter text

Clamp injection Common mode impedance requirements met Common mode impedance not met.

Modified test level: V Modulation ................................... : 80 % AM with 1 kHz

Other: Click or tap here to enter text Dwell time Click or tap here to enter text. (Example: 1 s) Step size ...................................... : Click or tap here to enter text. (Example: 1 %) Performance criterion .................. : A Supplementary information ......... : Click or tap here to enter text

Photo 5.5.1 ................................... : Immunity to conducted dist’s, induced by RF fields

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

Page 48 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

Advice to TRF Originator: Adjust the results table to match the levels of the standard. Test results for immunity to conducted disturbances, induced by radio-frequency fields Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz) Frequency range ......................... : 0,15 MHz – 80 MHz

Test level in V

Port under test Terminated port Observations Port name CDN type Port name CDN type

Click (Example: 10)

Click (Example: AC Mains)

M3 Click (Example: Earth)

M1 Click (Example: None)

Click (Example: 10)

Click (Example: Signal port 1)

AF2 Click (Example: Earth)

M1 Click (Example: Note 1)

Observations ............................... : Note 1:

Note 2: …

Supplementary information: Click or tap here to enter text Advice to TRF User: If the test is performed at more than one test item and/or applied mains voltage / mains frequency or over more than one frequency range, copy the table above. Advice to TRF user: Add here additional information (if applicable) for monitoring (e.g. recorded diagrams) or other information.

Page 49 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

5.6 IEC 61000-4-8 << Power frequency magnetic field immunity test >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............. : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test setup .................................... : Single Coil. Dimensions: 1 m x 1 m

Double coil: 1 m x 1 m Single Coil. Dimensions: 1 x 2,6 m Homogeneous field (Helmholtz coil). Dimensions: L x H m

0,1 m above GRP (ground reference plane) Other:

Supplementary test set up description ................................... :

Click or tap here to enter text

Performance criterion .................. : A Supplementary information ......... : Click or tap here to enter text

Photo 5.6.1 ................................... : Power frequency magnetic field immunity test

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

Page 50 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

Advice to TRF Originator: Adjust the results table to match the levels of the standard. Test results for power frequency magnetic field immunity test Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz)

Test frequency in Hz Duration in sec Test level

in A/m Recorded

current in coil in A

Axis Observations

50 Click 30 Click X Click (Example: None)

50 Click 30 Click Y Click (Example: Note 1)

50 Click 30 Click Z Click (Example: Note 2)

60 60 60

Field type ..................................... : Continuous field Short duration field

X, Y, Z are the three possible orientations of the magnetic field. Observations ............................... : Note 1:

Note 2: …

Supplementary information: Click or tap here to enter text Advice to TRF User: If the test is performed at more than one test item and/or applied mains voltage / frequency, copy the table above. Advice to TRF User: Add here additional information (if applicable) for monitoring (e.g. recorded diagrams) or other information.

Page 51 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

5.7 IEC 61000-4-11 << Voltage dips, short int’s and variations immunity test >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............ : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test method for 3 phase-to-phase system

Method A (preferred) Method B N/A

Test set up description ................ : Click or tap here to enter text Repetition rate ............................. : 10 s Number of dips or interruptions ... : 3 Performance criterion .................. : B (Voltage dips)

C (Short interruptions UT= 0 %) Supplementary information ......... : Click or tap here to enter text

Photo 5.7.1 ................................... : Voltage dips, short int’s and variations immunity test

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

Page 52 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

Advice to TRF Originator: Adjust the results table to match the levels and durations of the standard. Test results for voltage dips, interruptions and variations immunity test Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... :

Applied mains voltage / frequency

(UN) Duration in

cycles Test level in

% of UN Phase angle in degrees Type Observations

220 VAC / 50 Hz 0,5 0 0 Dip Click (Example: None)

220 VAC / 50 Hz 1 0 0 Dip Click (Example: Note 1)

220 VAC / 50 Hz 10/12 40 0 Dip Click (Example: Note 2)

220 VAC / 50 Hz 25/30 70 0 Dip

220 VAC / 50 Hz 250/300 0 0 Interruption

Observations ............................... : Note 1:

Note 2: …

Supplementary information ......... : Click or tap here to enter text Advice to TRF User: If the test is performed at more than one test item, copy the table above. Advice to TRF user: Add here additional information (if applicable) for monitoring (e.g. recorded diagrams) or other information. Test mains voltage / frequency... : 230 V / 50 Hz

Duration in cycles

Test level in % of UN

Phase angle in degrees Type Observations

0,5 0 0 Dip Click (Example: None)

1 0 0 Dip Click (Example: Note 1)

10/12 40 0 Dip Click (Example: Note 2)

25/30 70 0 Dip

250/300 0 0 Interruption

Page 53 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

5.8 IEC 61000-4-34 << Voltage dips, short int’s and variations, +16 A per phase >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............. : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test method for 3 phase-to-phase system

Method A (preferred) Method B

Test set up description ................ : Click or tap here to enter text Repetition rate ............................. : 10 s Number of dips or interruptions ... : 3 Performance criterion .................. : B (Voltage dips)

C (Short interruptions UT= 0 %) Supplementary information ......... : Click or tap here to enter text

Photo 5.8.1 .................................. : Voltage dips, short int’s and variations, +16 A per phase

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

Page 54 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

Advice to TRF Originator: Adjust the results table to match the levels and durations of the standard. Test results for voltage dips, interruptions and variations immunity test, +16 A per phase Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz)

Applied mains voltage / frequency

(UN) Duration in

cycles Test level in

% of UN Phase angle in degrees Type Observations

220 VAC / 50 Hz 0,5 0 0 Dip Click (Example: None)

220 VAC / 50 Hz 1 0 0 Dip Click (Example: Note 1)

220 VAC / 50 Hz 10/12 40 0 Dip Click (Example: Note 2)

220 VAC / 50 Hz 25/30 70 0 Dip

220 VAC / 50 Hz 250/300 0 0 Interruption

Observations ............................... : Note 1:

Note 2: …

Supplementary information ......... : Click or tap here to enter text Advice to TRF User: If the test is performed at more than one test item, copy the table above. Advice to TRF user: Add here additional information (if applicable) for monitoring (e.g. recorded diagrams) or other information.

Page 55 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

5.9 IEC 61000-4-29 << Voltage dips, short int’s and variations, d.c. input power >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............. : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test set up description ................ : Click or tap here to enter text Repetition rate ............................. : 10 s Number of dips or interruptions ... : 3 Performance criterion .................. : B (Voltage dips)

C (Short interruptions UT= 0 %) Supplementary information ......... : Click or tap here to enter text

Photo 5.9.1 .................................. : Voltage dips, short int’s and variations, d.c. input power

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

Page 56 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

Advice to TRF Originator: Adjust the results table to match the levels and durations of the standard. Test results for voltage dips, interruptions and variations immunity test, d.c. input power ports Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz)

Applied voltage in VDC

(UN) Duration in

cycles Test level in

% of UN Impedance Type Observations

24 1 0 Low Dip Click (Example: None)

24 10/12 40 Low Dip Click (Example: Note 1)

24 25/30 70 Low Dip Click (Example: Note 2)

24 250/300 0 Low Dip

24 250/300 0 High Interruption

24 10/12 80 - Variation

24 10/12 85 - Variation

24 10/12 120 - Variation

Observations* .............................. : Note 1:

Note 2: …

Supplementary information: Click or tap here to enter text Advice to TRF User: If the test is performed at more than one test item, copy the table above. Advice to TRF user: Add here additional information (if applicable) for monitoring (e.g. recorded diagrams) or other information.

Page 57 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

5.10 IEC 61000-4-13 << Harmonics and interharmonics at a.c. power port >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............. : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test set up description ................ : Click or tap here to enter text Performance criterion .................. : Advice to TRF originator: To be defined by the product standard Supplementary information ......... : Click or tap here to enter text

Photo 5.10.1 ................................ : Harmonics and interharmonics at a.c. power port

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

Page 58 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

Test results according to table 7 of IEC 61000-4-13 – Time related function, “flat curve” Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz)

Applied mains voltage / frequency (UN)

Test level for class

Time at each dwell point

in min Observations

230 VAC / 50 Hz 1 or 2 or 4 X 2 Click (Example: None)

230 VAC / 50 Hz 1 or 2 or 4 X 2 Click (Example: Note 1)

Observations ............................... : Note 1:

Note 2: …

Supplementary information ......... : Click or tap here to enter text Test results according to table 8 of IEC 61000-4-13 – Harmonic combination, “over swing” Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz) Applied mains

voltage / frequency (UN)

h 3 5 Time at each dwell point

in min Observations

230 VAC / 50 Hz

% of UN 4 % /180° 3 % / 0° 2 Click (Example: None)

230 VAC / 50 Hz

% of UN 6 % /180° 4 % / 0° 2 Click (Example: Note 1)

230 VAC / 50 Hz

% of UN 8 % /180° 5 % / 0° 2 Click (Example: Note 2)

230 VAC / 50 Hz

% of UN X % /180° X % / 0° 2 Click

Observations ............................... : Note 1:

Note 2: …

Supplementary information: Click or tap here to enter text

Page 59 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

Test results according to table 9 of IEC 61000-4-13 – Sweep in frequency test levels Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz) Applied mains

voltage / frequency (UN)

Frequency range Freq. step Test level

in % of UN Time at each dwell point

in sec Observations

230 VAC / 50 Hz

0.33 x f1 to 2 x f1

0.1 x f1 2 / 3 / 4.5 / open

> 120 Click (Example: None)

230 VAC / 50 Hz

2 x f1 to 10 x f1

0.2 x f1 5 / 9 / 14 / open > 120 Click (Example: Note 1)

230 VAC / 50 Hz

10 x f1 to 20 x f1

0.2 x f1 4 / 4.5 / 9 / open

> 120 Click (Example: Note 2)

230 VAC / 50 Hz

20 x f1 to 30 x f1

0.5 x f1 2 / 2 / 6 / open > 120 Click

230 VAC / 50 Hz

30 x f1 to 40 x f1

0.5 x f1 2 / 2 / 4 / open > 120 Click

Observations ............................... : Note 1:

Note 2: …

Supplementary information: Click or tap here to enter text Test results according to table 11 of IEC 61000-4-13 – Meister curve test levels Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz) Applied mains

voltage / frequency (UN)

Frequency range Freq. step Test level

in % of UN Time per decade in min

Observations

230 VAC / 50 Hz

0.33 x f1 to 2 x f1

0.1 x f1 3 / 4 / open > 5 Click (Example: None)

230 VAC / 50 Hz

2 x f1 to 10 x f1

0.2 x f1 9 / 10 / open > 5 Click (Example: Note 1)

230 VAC / 50 Hz

10 x f1 to 20 x f1

0.2 x f1 4500/f or open

> 5 Click (Example: Note 2)

230 VAC / 50 Hz

20 x f1 to 40 x f1

0.5 x f1 4500/f or open

> 5 Click

Observations ............................... : Note 1:

Note 2: …

Supplementary information ......... : Click or tap here to enter text Advice to TRF User: Add here additional information (if applicable) for monitoring (e.g. recorded diagrams) or other information.

Page 60 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

5.11 IEC 61000-4-16 << Conducted, common mode disturbances 0 Hz to 150 kHz >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............. : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test setup .................................... : Equipment located (0,1 ± 0,05) m above ground plane

Other: -- Supplementary test set up description ................................... :

Click or tap here to enter text

Electromagnetic environment class ............................................ :

Class 1 Class 2 Class 3 X Class X : --

Dwell time .................................... : Click or tap here to enter text. (Example: 1 s) Step size ...................................... : Click or tap here to enter text. (Example: 1 %) Performance criterion .................. : Advice to TRF Originator: To be defined by the product standard Supplementary information ......... : Click or tap here to enter text

Photo 5.11.1 ................................ : Conducted, common mode disturbances 0 Hz to 150 kHz

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Page 61 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

Advice to TRF Originator: Adjust the results table to match the levels of the standard. Test results for immunity to conducted, common mode disturbances in the range 0 Hz to 150 kHz Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz) Frequency range ......................... : 15 Hz – 150 kHz

Port name Test level in V Coupling CDN type / ID Observations

Click (Example: AC Power) 30 CDN Click (Example: M3, ID 590)

Click (Example: None)

Click (Example: AC Power) - - Click (Example: Note 1)

Click (Example: Digital out 1) - - Click (Example: Note 2)

Click Observations ............................... : Note 1:

Note 2: …

Supplementary information ......... : Click or tap here to enter text Advice to TRF User: If the test is performed at more than one test item and/or applied mains voltage / mains frequency, copy the table above.

Page 62 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

Advice to TRF user or TRF Originator: The following tables can used for additional results for conducted, common—mode disturbances. Test results for immunity to conducted disturbances: Continuous disturbance Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz)

Port name Test level in V Frequency Dwell time

in sec Observations

Click (Example: AC Power) 3 DC 120 Click (Example: None)

Click (Example: AC Power) 3 DC reversed 120 Click (Example: Note 1)

Click (Example: AC Power) 3 50 Hz 120 Click (Example: Note 2)

Click (Example: AC Power) 3 16 2/3 Hz 120 Click Observations ............................... : Note 1:

Note 2: Supplementary information ......... : Click or tap here to enter text

Advice to TRF User: If the test is performed at more than one test item and/or applied mains voltage / mains frequency, copy the table above. Test results for immunity to conducted disturbances: Short duration disturbance (typically 1 s) Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz)

Port name Test level in V Frequency Dwell time

in sec Observations

Click (Example: AC Power) 30 DC 1 Click (Example: None)

Click (Example: AC Power) 30 DC reversed 1 Click (Example: Note 1)

Click (Example: AC Power) 30 50 Hz 1 Click (Example: Note 2)

Click (Example: AC Power) 30 16 2/3 Hz 1 Click Observations ............................... : Note 1:

Note 2: Supplementary information ......... : Click or tap here to enter text

Advice to TRF User: If the test is performed at more than one test item and/or applied mains voltage / mains frequency, copy the table above.

Page 63 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

5.12 IEC 61000-4-17 << Ripple on d.c. input power port >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............. : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test set up description ................ : Click or tap here to enter text Performance criterion .................. : Advice to TRF Originator: To be defined by the product standard Supplementary information ......... : Click or tap here to enter text

Photo 5.12.1 ................................ : Ripple on d.c. input power port

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

Page 64 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

Test results for ripple on d.c. input power ports immunity test Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz)

Applied mains voltage (Umax, Umin) in V

Test Level in %

Dwell time in min

Observations

12 10 10 Click (Example: None)

5 10 10 Click (Example: Note 1)

Click (Example: Note 2)

Observations ............................... : Note 1: Note 2: …

Waveform of the ripple signal ...... : Add graphical representation of the applied ripple signal

Supplementary information ......... : Click or tap here to enter text

Page 65 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

5.13 IEC 61000-4-18 << Damped oscillatory wave >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Rationale for verdict N/A ............. : Click or tap here to enter text

Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test set up description ................ : Click or tap here to enter text Deviations from wiring or distance requirements of the standard ...... :

The distance requirements of the standard could be met The distance requirements of the standard could not be met

Deviation Rationale -- -- -- --

Application of special DC CDN (Clause C.1) ................................ :

No special DC CDN is required Special DC-CDN is required (Clause 8.3 and Figure C.1)

Deviation Description and Rationale -- -- -- --

Duration of the test per port ........ : FDOWG 1 min.

SDOWG 1 min. No pauses

Performance criterion .................. : Advice to TRF Originator: To be defined by the product standard Supplementary information ......... : Click or tap here to enter text

Page 66 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

Photo 5.13.1 ................................ : Damped oscillatory wave

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

Page 67 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

Advice to TRF Originator: Adjust the results table to match the levels of the standard. Test results for damped oscillatory wave immunity test Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz)

Port name Frequency Test level in kV Polarity Coupling Observations

Click (Example: AC Power)

1 MHz 1 P, N L-PE, CM Click (Example: None)

Click (Example: AC Power)

10 MHz 0,5 P, N L-N, DM Click (Example: Note 1)

Click (Example: AC Power)

1 MHz 0,5 P, N L-N, DM Click (Example: Note 2)

Click (Example: Digital out 1)

1 MHz 2,5 P, N L-L, DM Click

Click (Example: Digital out 1)

1 MHz 1 P, N L-L, DM Click

Click (Example: AC Power)

10 MHz 1 P, N L-L, DM Click

Click (Example: AC Power)

10 MHz 1 P, N BC, DM Click

P = Positive polarity of the damped oscillatory wave impulses N = negative polarity of the damped oscillatory wave impulses L-PE = Line to Protective Ground; L-N = Line to Neutral; L-L = Line to Line; BC = Between cabinets CM = Common – Mode; CM-C = Common mode with capacitive coupling clamp DM = Differential – Mode Observations ............................... : Note 1:

Note 2: …

Supplementary information ......... : Click or tap here to enter text Advice to TRF User: If the test is performed at more than one test item and/or applied mains voltage / frequency, copy the table above.

Page 68 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

5.14 IEC 61000-4-39 << Radiated fields in close proximity >>

Name ........................................... : Click or tap here to enter text Date ............................................. : Click or tap to enter a date. Performed tests ........................... : Magnetic field immunity 9 kHz to 150 kHz

Magnetic field immunity 150 kHz to 26 MHz Radiated immunity test 380 MHz to 6 GHz

Rationale for verdict N/A ............. : Click or tap here to enter text (For each range not performed) Magnetic field immunity 9 kHz to 150 kHz Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test set up description ................ : Click or tap here to enter text Performance criterion .................. : Advice to TRF Originator: To be defined by the product standard Selected window size .................. : 100 mm x 100 mm (Maximum)

Other: -- Test distance d ............................ : (50 ± 3) mm

Other: -- Frequency steps .......................... : 10 kHz

Other: -- Supplementary information ......... : Click or tap here to enter text

Magnetic field immunity 150 kHz to 26 MHz Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test set up description ................ : Click or tap here to enter text Performance criterion .................. : Advice to TRF Originator: To be defined by the product standard Selected window size .................. : 80 mm x 80 mm (Maximum)

Other: -- Test distance d ............................ : (50 ± 3) mm

Other: -- Frequency steps .......................... : 150 kHz to 1 MHz: 100 kHz

1 MHz to 26 MHz: .............. 1 MHz Other: --

Supplementary information ......... : Click or tap here to enter text

Page 69 of 83 Report No. xxxxx

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Radiated immunity test 380 MHz to 6 GHz Test location (stand) .................... : Click or tap here to enter text. (Example: EMC room1, setup B) Test set up description ................ : Click or tap here to enter text Performance criterion .................. : Advice to TRF Originator: To be defined by the product standard Test distance d ............................ : (100 ± 3) mm

Other: -- Frequency steps .......................... : 1 %

Other: -- Supplementary information ......... : Click or tap here to enter text

Photo 5.14.1 ................................ : Radiated fields in close proximity

Advice to TRF User: The number of photos printed here is decided by the laboratory. If more (or less) photos are needed, please copy (or delete) the tables. To update photo numbering: Select the whole document (Ctrl-A) and press F9 to update all fields at once.

Page 70 of 83 Report No. xxxxx

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Advice to TRF Originator: Adjust the results table to match the frequencies and levels of the standard. Test results for magnetic field immunity 9 kHz to 150 kHz Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz) Dwell time .................................... : Click or tap here to enter text. (Example: 1 s) Test points (Windows) ................. : All windows have been tested

Selected critical points as described by the manufacturer have been tested. See below the points which have been tested. See also additional photos (if applicable).

Frequency / range Test level in A/m Point / Window Modulation Observations

30 kHz 8 All points on photo below CW

Click (Example: None)

134.2 kHz 65 All points on photo below

Pulse modulation 2,1 kHz

Click (Example: Note 1)

150 kHz 65 All points on photo below

80 % AM 1 kHz

Click (Example: Note 2)

9 kHz – 150 kHz 3 Left side of EUT PM with Duty cycle 50 % Click

9 kHz – 150 kHz 3 Right side of EUT

PM with Duty cycle 50 % Click

9 kHz – 150 kHz 3 Front side of EUT

PM with Duty cycle 50 % Click

9 kHz – 150 kHz 3 Back side of EUT

PM with Duty cycle 50 % Click

9 kHz – 150 kHz 3 Top side of EUT PM with Duty cycle 50 % Click

9 kHz – 150 kHz 7.5 All points on photo below

PM with Duty cycle 50 %, 50

kHz Click

Observations ............................... : Note 1: Note 2: …

Supplementary information ......... : Click or tap here to enter text Advice to TRF User: If the test is performed at more than one test item and/or applied mains voltage / frequency, copy the table above.

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Advice to TRF Originator: Adjust the results table to match the frequencies and levels of the standard. Test results for magnetic field immunity 150 kHz to 26 MHz Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz) Dwell time Click or tap here to enter text. (Example: 1 s) Test points (Windows) ................. : All windows have been tested

Selected critical points as described by the manufacturer have been tested. See below the points which have been tested. See also additional photos (if applicable).

Frequency / range Test level in A/m Point / Window Modulation Observations

All points on photo below CW Click (Example:

None)

All points on photo below

Pulse modulation

2,1 kHz

Click (Example: Note 1)

All points on photo below

80 % AM 1 kHz

Click (Example: Note 2)

Left side of EUT PM with Duty cycle 50 % Click

Right side of EUT

PM with Duty cycle 50 % Click

Front side of EUT

PM with Duty cycle 50 % Click

Back side of EUT

PM with Duty cycle 50 % Click

Top side of EUT

PM with Duty cycle 50 % Click

All points on photo below

PM with Duty cycle 50 %, 50

kHz Click

Observations ............................... : Note 1: Note 2: …

Supplementary information: Click or tap here to enter text Advice to TRF User: If the test is performed at more than one test item and/or applied mains voltage / frequency, copy the table above.

Page 72 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

Advice to TRF Originator: Adjust the results table to match the frequencies and levels of the standard. Test results for radiated immunity test 380 MHz to 6 GHz Test item no(s) ref. cl. 1.2 ........... : Click or tap here to enter text Operating mode no(s) ref. cl. 1.6 : Click or tap here to enter text Test setup no(s) ref. cl. 3.3 ......... : Click or tap here to enter text Test mains voltage / frequency ... : Click or tap here to enter text. (Example: 230 VAC / 50 Hz) Dwell time Click or tap here to enter text. (Example: 1 s) Test points (Windows) ................. : All windows have been tested

Selected critical points as described by the manufacturer have been tested. See below the points which have been tested. See also additional photos (if applicable).

Frequency / range Test level in V/m

Point / Window Modulation Observations

All points on photo below CW Click (Example:

None)

All points on photo below

Pulse modulation

2,1 kHz

Click (Example: Note 1)

All points on photo below

80 % AM 1 kHz

Click (Example: Note 2)

Left side of EUT

PM with Duty cycle 50 % Click

Right side of EUT

PM with Duty cycle 50 % Click

Front side of EUT

PM with Duty cycle 50 % Click

Back side of EUT

PM with Duty cycle 50 % Click

Top side of EUT

PM with Duty cycle 50 % Click

All points on photo below

PM with Duty cycle 50 %, 50

kHz Click

Observations ............................... : Note 1: Note 2: …

Supplementary information ......... : Click or tap here to enter text Advice to TRF User: If the test is performed at more than one test item and/or applied mains voltage / frequency, copy the table above.

Page 73 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

5.15 << IEC 60601-1-2 Accompanying documents >>

IEC 60601-1-2

Clause Requirement + Test Result - Remark Verdict

Note: For items that require a presence check of the RISK MANAGEMENT PROCESS or RISK MANAGEMENT FILE, use PC in the Verdict column when the item is confirmed as present in the associated documents.

4 GENERAL REQUIREMENTS

4.1 RISKS resulting from reasonably foreseeable ELECTROMAGNETIC DISTURBANCES shall be taken into account in THE RISK MANAGEMENT PROCESS.

RMF Reference Document:

4.2 Non-ME EQUIPMENT used in an ME SYSTEM

Check 16.1 of general standard, checked by inspection of the RISK MANAGEMENT FILE and OBJECTIVE EVIDENCE of compliance with the respective EMC standards, or by the tests of this collateral standard

RMF Reference Document:

Non- ME EQUIPMENT used in an ME SYSTEM shall comply with IEC and ISO EMC standards applicable to that equipment, checked by inspection of the RISK MANAGEMENT FILE and OBJECTIVE EVIDENCE of compliance with the respective EMC standards, or by the tests of this collateral standard

RMF Reference Document:

Non- ME EQUIPMENT used in an ME SYSTEM for which the intended EM ENVIRONMENT could result in the loss of BASIC SAFETY or ESSENTIAL PERFORMANCE of the ME SYSTEM due to the non- ME EQUIPMENT shall be tested according to the requirements of this collateral standard, checked by inspection of the RISK MANAGEMENT FILE and OBJECTIVE EVIDENCE of compliance with the respective EMC standards, or by the tests of this collateral standard

RMF Reference Document:

4.3.1 Configurations

ME EQUIPMENT and ME SYSTEMS shall be tested in representative configurations, consistent with INTENDED USE, that are most likely to result in unacceptable RISK. as determined by the MANUFACTURER. This shall be determined using RISK ANALYSIS, experience, engineering analysis, or pretesting. Compliance is checked by inspection of the test report and the RISK MANAGEMENT FILE.

See appended Item and RMF Reference Document:

4.3.3 Power input and frequencies See appended Item 1

IEC 60601-1-2

Clause Requirement + Test Result - Remark Verdict

Note: For items that require a presence check of the RISK MANAGEMENT PROCESS or RISK MANAGEMENT FILE, use PC in the Verdict column when the item is confirmed as present in the associated documents.

5 IDENTIFICATION, MARKING AND DOCUMENTS

5.1 Additional requirements for marking on the outside of ME EQUIPMENT and ME SYSTEMS specified for use only in a shielded location SPECIAL ENVIRONMENT

Page 74 of 83 Report No. xxxxx

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IEC 60601-1-2

Clause Requirement + Test Result - Remark Verdict

Note: For items that require a presence check of the RISK MANAGEMENT PROCESS or RISK MANAGEMENT FILE, use PC in the Verdict column when the item is confirmed as present in the associated documents.

ME EQUIPMENT and ME SYSTEMS specified for use only in a shielded location SPECIAL ENVIRONMENT shall be labelled with a CLEARLY LEGIBLE warning that they should be used only in the specified type of shielded location

5.2 ACCOMPANYING DOCUMENTS

5.2.1 Instructions for use

5.2.1.1 General

a) A statement of the ENVIRONMENTS for which the ME EQUIPMENT or ME SYSTEM is suitable. Relevant exclusions, as determined by RISK ANALYSIS, shall also be listed.

RMF Reference Document:

b) The ESSENTIAL PERFORMANCE of ME EQUIPMENT and a description of what the operator can expect if the ESSENTIAL PERFORMANCE is lost or degraded due to EM disturbances.

c) A warning regarding stacking and location close to other equipment

d) List of cables, transducers and accessories

e) A warning that other cables and accessories may negatively affect EMC performance

f) A statement that portable RF communications equipment. Including antennas, can effect ME EQUIPMENT. The warning should include a use distance such as “…be used no closer than 30 cm (12 inches) to any part of the [ME EQUIPMENT or ME SYSTEM], including cables specified by the manufacturer”

5.2.1.2 Requirements applicable to ME EQUIPMENT and ME SYSTEMS classified class A according to CISPR 11

ME EQUIPMENT and ME SYSTEMS that are classified class A according to CISPR 11, the instructions for use shall include the following note:

NOTE The EMISSIONS characteristics of this equipment make it suitable for use in industrial areas and hospitals (CISPR 11 class A). If it is used in a residential ENVIRONMENT (for which CISPR 11 class B is normally required) this equipment might not offer adequate protection to radio-frequency communication services. The user might need to take mitigation measures, such as relocating or re-orienting the equipment.

5.2.2 Technical description

5.2.2.1 Requirements applicable to all ME EQUIPMENT and ME SYSTEMS

Page 75 of 83 Report No. xxxxx

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IEC 60601-1-2

Clause Requirement + Test Result - Remark Verdict

Note: For items that require a presence check of the RISK MANAGEMENT PROCESS or RISK MANAGEMENT FILE, use PC in the Verdict column when the item is confirmed as present in the associated documents.

The technical description shall describe precautions to be taken to prevent adverse events to the PATIENT and OPERATOR due to ELECTROMAGNETIC DISTURBANCES

Reference Document:

a) Compliance for each EMISSION and IMMUNITY standard or test specified by this collateral standard, e.g. EMISSIONS class and group and I IMMUNITY TEST LEVEL

b) Any deviations from this collateral standard and allowances used

Reference Document:

c) All necessary instructions for maintaining BASIC SAFETY and ESSENTIAL PERFORMANCE with regard to ELECTROMAGNETIC DISTURBANCES for the EXPECTED SERVICE LIFE

5.2.2.2 Requirements applicable to ME EQUIPMENT specified for use only in shielded location SPECIAL ENVIRONMENT

The technical description shall include the following information:

a) A warning to the effect that: WARNING: Failure to use this equipment in the specified type of shielded location could result in degradation of performance, interference with other equipment or interference with radio services

b) Specifications for shielded location including: – minimum RF shielding effectiveness; – for each cable that enters or exits the shielded location, the minimum RF filter attenuation; and – the frequency range(s) over which the specifications apply

Reference Document:

c) Test methods for measurement of RF shielding effectiveness and RF filter attenuation

d) one or more of the following and a recommendation that a notice containing this information be posted at the entrance(s) to the shielded location: – a specification of the EMISSIONS characteristics of other equipment allowed inside the shielded location with the ME EQUIPMENT or ME SYSTEM; – a list of specific equipment allowed; – a list of types of equipment prohibited.

Reference Document:

5.2.2.3 Requirements applicable to ME EQUIPMENT that intentionally receive RF electromagnetic energy shall include the following information: - each frequency or frequency of reception - the preferred frequency or frequency band, if applicable, and - the bandwidth of the receiving section of the ME EQUIPMENT in those bands

Reference Document:

Page 76 of 83 Report No. xxxxx

TRF No. IEC (or ISO) xxxxx_xy

IEC 60601-1-2

Clause Requirement + Test Result - Remark Verdict

Note: For items that require a presence check of the RISK MANAGEMENT PROCESS or RISK MANAGEMENT FILE, use PC in the Verdict column when the item is confirmed as present in the associated documents.

5.2.2.4 Requirements applicable to the ME EQUIPMENT that include RF transmitters the technical description shall include: Frequency or frequency band of transmission, the type and frequency characteristics of the modulation and the EFFECTIVE RADIATED POWER

Reference Document:

5.2.2.5 Requirements applicable to PERMANENTLY INSTALLED LARGE ME EQUIPMENT and LARGE ME SYSTEMS

The technical description shall include the following information:

a) A statement that an exemption has been used and that the equipment has not been tested for radiated RF IMMUNITY over the entire frequency range 80 MHz to 6 GHz

Reference Document:

b) A warning to the effect that “WARNING: This equipment has been tested for radiated RF IMMUNITY only at selected frequencies, and use nearby of emitters at other frequencies could result in improper operation”

c) A list of the frequencies and modulations used to test the IMMUNITY of the ME EQUIPMENT or ME SYSTEM

5.2.2.6 Requirements applicable to ME EQUIPMENT that claim compatibility with HF SURGICAL EQUIPMENT

The technical description shall include in the technical description a statement of HF SURGICAL EQUIPMENT compatibility and the conditions of INTENDED USE during HF surgery

Reference Document:

IEC 60601-1-2

Clause Requirement + Test Result - Remark Verdict

6.1 Documentation of tests - General

The documentation of tests shall contain all information necessary to facilitate adequate planning (test plan) and execution of tests

See appended Item 1

6.2 Test Plan

Prior to the start of formal testing, a detailed test plan shall be provided to the test laboratory. Note: title / name / version of test plan in remark section.

See attached annex X

7 ELECTROMAGNETIC EMISSIONS requirements for ME EQUIPMENT and ME SYSTEMS

Clause Requirement + Test Result - Remark Verdict

7.1.1 Protection of radio services and other equipment - General

Unless otherwise specified herein, ME EQUIPMENT and ME SYSTEMS shall comply with CISPR 11

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7 ELECTROMAGNETIC EMISSIONS requirements for ME EQUIPMENT and ME SYSTEMS

Clause Requirement + Test Result - Remark Verdict

7.1.2 Operating modes

During EMISSIONS testing, ME EQUIPMENT or ME SYSTEM shall be tested in the modes that maximize EMISSIONS. In addition to active modes, inclusion of standby mode should be considered. The operating modes selected for testing should be documented in the test plan and shall be documented in the test report

See appended Item 1

7.1.3 Multimedia Equipment

Multimedia equipment connected to ME EQUIPMENT or ME SYSTEM shall comply with CISPR 32. If CISPR 32 class A equipment is supplied as part of the ME SYSTEM, the ME SYSTEM shall be classified class A

7.1.4 Subsystems

Compliance with CISPR 11 may be demonstrated by testing each subsystem of an ME SYSTEM on a subsystem basic, provided the requirements of CISPR 11 for evaluation of equipment that interacts with other equipment to form a system are met

7.1.5 ME EQUIPMENT and ME SYSTEMS specified for use only in a shielded location SPECIAL ENVIRONMENT

For ME EQUIPMENT and ME SYSTEMS that are specified for use only in a shielded location SPECIAL ENVIRONMENT, the ELECTROMAGNETIC radiation disturbance limits of CISPR 11 may be increased, when tests are performed on a test site, by an amount up to the applicable specified value of minimum RF shielding effectiveness, provided the minimum RF shielding effectiveness specification

For ME EQUIPMENT and ME SYSTEMS that are specified for use only in a shielded location SPECIAL ENVIRONMENT, the mains terminal disturbance voltage limits of CISPR 11 may be increased, when tests are performed on a test site, by an amount up to the applicable specified value of minimum RF filter attenuation for all cables that enter or exit the shielded location, provided the minimum RF filter attenuation specification

a) The specified RF shielding effectiveness and RF filter attenuation shall;

- be expressed in dB; - be rounded to the nearest integer; and - be at least 20 dB.

b) The RF shielding effectiveness and RF filter attenuation specification shall include the frequency range over which the RF shielding effectiveness and RF filter attenuation apply, and this frequency range shall be at least one decade in width

Reference to Document:

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7 ELECTROMAGNETIC EMISSIONS requirements for ME EQUIPMENT and ME SYSTEMS

Clause Requirement + Test Result - Remark Verdict

c) The specified value(s) for minimum RF filter attenuation shall be identical to the specified value(s) for minimum RF shielding effectiveness in each frequency range for which they are specified

Reference to Document:

d) In frequency ranges for which the minimum RF shielding effectiveness and RF filter attenuation are not specified or are specified to be less than 20 dB, the RF shielding effectiveness and RF filter attenuation shall be assumed to be 0 dB for the purpose of this collateral standard

Reference to Document:

7.1.6 ME EQUIPMENT and ME SYSTEMS that include radio equipment

ME EQUIPMENT and ME SYSTEMS that include radio equipment (e.g. RF transmitters, receivers, transceivers) and have been tested together with the radio equipment and found to comply with applicable national radio regulations are exempt from testing to CISPR ELECTROMAGNETIC DISTURBANCE requirements.

7.1.7 ME EQUIPMENT whose main functions are performed by motors and switching or regulating devices

ME EQUIPMENT whose main functions are performed by motors and switching or regulating devices may be classified in accordance with CISPR 14-1

7.1.8 ME EQUIPMENT and ME SYSTEMS containing X-ray generators

For diagnostic X-ray generators and ME SYSTEMS that include X-ray generators operating in INTERMITTENT MODE, the quasi-peak limits to discontinuous radiated and conducted DISTURBANCES can be relaxed by 20 dB

7.1.12 PERMANENTLY INSTALLED LARGE ME EQUIPMENT and LARGE ME SYSTEMS

PERMANENTLY INSTALLED LARGE ME EQUIPMENT and LARGE ME SYSTEMS shall be TYPE TESTED by at least one of the following methods: – on a test site as a system; – on a test site on a subsystem basis; – in situ as a system at the premises of a RESPONSIBLE

ORGANIZATION

TEST METHOD SELECTED

7.2 Protection of the PUBLIC MAINS NETWORK

7.2.1 Harmonic distortion

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7 ELECTROMAGNETIC EMISSIONS requirements for ME EQUIPMENT and ME SYSTEMS

Clause Requirement + Test Result - Remark Verdict

If the ME EQUIPMENT OR ME SYSTEMS with a RATED a.c. mains network voltage greater than or equal to 220 V a.c. line-to-neutral and less than or equal to 16 A per phase is intended to be connected a PUBLIC MAINS NETWORK it shall comply with the requirements of IEC 61000-3-2

Compliance is checked by inspection of the ACCOMPANYING DOCUMENTS and the test report.

See Appended Item 5

7.2.2 Voltage fluctuations and flicker

If the ME EQUIPMENT OR ME SYSTEMS with a RATED a.c. mains network voltage greater than or equal to 220 V a.c. line-to-neutral and less than or equal to 16 A per phase is intended to be connected a PUBLIC MAINS NETWORK it shall comply with the requirements of IEC 61000-3-3.

Compliance is checked by inspection of the ACCOMPANYING DOCUMENTS and the test report.

See Appended Item 6

IEC 60601-1-2

Clause Requirement + Test Result - Remark Verdict

Note: For items that require a presence check of the RISK MANAGEMENT PROCESS or RISK MANAGEMENT FILE, use PC in the Verdict column when the item is confirmed as present in the associated documents.

8 ELECTROMAGNETIC IMMUNITY requirements for ME EQUIPMENT and ME SYSTEMS

For ME EQUIPMENT and ME SYSTEMS for which the INTENDED USE includes types of transportation or other locations as in the HOME HEALTHCARE ENVIRONMENT if additional IMMUNITY tests or IMMUNITY TEST LEVELS that are higher these additional tests to these higher IMMUNITY TEST LEVELS shall be documented

Reference to Document:

ME EQUIPMENT or ME SYSTEMS intended for use in the EMERGENCY MEDICAL SERVICES ENVIRONMENT for the HOME HEALTHCARE ENVIRONMENT. If locations in the EMERGENCY MEDICAL SERVICES ENVIRONMENT are identified for which the specifications are for the HOME HEALTHCARE ENVIRONMENT are not adequate, then Annex E may be used to determine appropriate IMMUNITY TEST LEVELS

Document Reference:

Before IMMUNITY testing begins, the MANUFACTURER shall determine specific, detailed IMMUNITY pass/fail criteria, based on applicable part two standards or RISK MANAGEMENT, for BASIC SAFETY and ESSENTIAL PERFORMANCE with regard to EM DISTURBANCES. The pass/fail criteria and the monitoring specification should be included in the test plan and shall be included in the test report and the RISK MANAGEMENT FILE

RMF Reference Document:

Page 80 of 83 Report No. xxxxx

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IEC 60601-1-2

Clause Requirement + Test Result - Remark Verdict

Note: For items that require a presence check of the RISK MANAGEMENT PROCESS or RISK MANAGEMENT FILE, use PC in the Verdict column when the item is confirmed as present in the associated documents.

8 ELECTROMAGNETIC IMMUNITY requirements for ME EQUIPMENT and ME SYSTEMS

8.2 PATIENT physiological simulation

If a PATIENT simulation is required to verify normal operation of the ME EQUIPMENT or ME SYSTEM, it shall be provided during IMMUNITY testing

Document reference to Type of patient stimulator or setup used:

Prior to the beginning of the test, the amplitude of simulated PATIENT physiological signals shall be adjusted to be consistent with normal operation of the ME EQUIPMENT or ME SYSTEM, as specified by the MANUFACTURER

Document reference to Patient physiological settings used:

8.5 Subsystems

When subsystems are tested to demonstrate compliance, normal operating conditions are simulated

The RISK MANAGEMENT PROCESS shall be used to determine whether subsystem testing is allowed.

RMF Reference Document:

8.6 Permanently installed LARGE ME EQUIPMENT and LARGE ME SYSTEMS

PERMANENTLY INSTALLED LARGE ME EQUIPMENT and LARGE ME SYSTEMS shall be TYPE TESTED by at least one of the following methods:

– on a test site as a system; – on a test site on a subsystem basis; – in situ as a system at the premises of a RESPONSIBLE

ORGANIZATION

Test Method selected Test Method selected

8.7 Operating Modes

Operating Modes and settings See appended Item 1 and RMF Reference Document:

8.8 Non- ME EQUIPMENT

Non- ME EQUIPMENT (e.g. ITE) that is a part of an ME SYSTEM shall fulfil the pass/fail criteria and IMMUNITY TEST LEVELS of Clause 8 if it has been determined, as a result of the RISK MANAGEMENT PROCESS, that the non- ME EQUIPMENT could affect the BASIC SAFETY or ESSENTIAL PERFORMANCE of the ME SYSTEM. Compliance is checked by inspection of the test report and the RISK MANAGEMENT FILE.

8.9 IMMUNITY TEST LEVELS

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IEC 60601-1-2

Clause Requirement + Test Result - Remark Verdict

Note: For items that require a presence check of the RISK MANAGEMENT PROCESS or RISK MANAGEMENT FILE, use PC in the Verdict column when the item is confirmed as present in the associated documents.

8 ELECTROMAGNETIC IMMUNITY requirements for ME EQUIPMENT and ME SYSTEMS

IMMUNITY TEST LEVELS based on ENVIRONMENT location of INTENDED USE

See Appended Items 7.2 to 7.3 and 7.5 to 7.10 and RMF Reference Document:

8.10 IMMUNITY to proximity fields from RF wireless communication equipment

ENCLOSURE PORT of ME EQUIPMENT and ME SYSTEMS shall, be tested as specified in Table 9 as per IEC 61000-4-3

See Appended Item Tables 7.4 and RMF Reference Document:

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6 Measurement instrumentation uncertainties and decision rule 6.1 Measurement uncertainty Where relevant, the following measurement instrumentation uncertainty levels have been estimated for tests performed on the apparatus: Advice to TRF User: Delete rows not applicable. If a value for UCISPR is not specified, enter N/A.

Type of disturbance / Test method Calculated expanded uncertainty ULab UCISPR

Conducted disturbance at AC mains and other port power using a V-AMN (150 kHz to 30 MHz)

3,4

Conducted disturbance at AC mains port using a voltage probe - 1500 Ohm (9 kHz - 30 MHz)

2,9

Conducted disturbance at telecommunication port using CP (9 kHz - 30 MHz)

2,9

Conducted disturbance at telecommunication port using CVP (150 kHz - 30 MHz)

3,9

Disturbance power (30 MHz to 300 MHz) 4,5 Radiated disturbance (disturbance current in a LLAS) 3,3 Radiated disturbance (disturbance current in a Loop antenna 10 kHz to 30 MHz)

N/A

Radiated disturbance (electrical field strength at an OATS / SAC; 30 MHz - 200 MHz; biconical antenna; 3 m or 10 m)

6,3

Radiated disturbance (electrical field strength at an OATS / SAC; 200 MHz - 1000 MHz; LPDA antenna; 3 m or 10 m)

6,3

Radiated disturbance (electrical field strength at an OATS / SAC; 30 MHz - 1000 MHz; Hybrid antenna; 3 m or 10 m)

6,3

Radiated disturbance (electrical field strength in a FAR; 1 GHz - 6 GHz)

5,2

Radiated disturbance (electrical field strength in a FAR; 6 GHz - 18 GHz)

5,5

Radiated disturbance (in a GTEM; 30 MHz - 1000 MHz) 6,3 Harmonic current emissions N/A Flicker N/A Electrostatic Discharge Immunity Test (ESD) N/A Radiated, RF, electromagnetic field immunity test N/A Electrical fast transients / burst immunity test N/A Surge immunity test N/A Immunity to conducted disturbances, induced RF Fields N/A Power frequency magnetic field immunity test N/A Voltage dips, short int’s and variations immunity test N/A Voltage dips, short int’s and variations, +16 A per phase N/A Voltage dips, short int’s and variations, d.c. input power N/A Damped oscillatory magnetic field immunity and ringwave N/A Harmonics and interharmonics at a.c. power port N/A Conducted, common mode disturbances 0 Hz to 150 kHz N/A Ripple on d.c. input power port N/A Damped oscillatory wave N/A Radiated fields in close proximity N/A

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6.2 Decision rule

7 List of test equipment Explanation to the TRF user: The test equipment either be shown at this section or immediately after the photos at each test section. The minimum contents of the information for the test equipment necessary to be added:

• Reference to test stand, test name or test ID • Equipment ID • Equipment description • Last calibration date • Calibration due date

Reference to test stand or test name (ID):

Equipment ID Equipment description Last Calibration date

Calibration due date