WH-1404, Rev. Feb 97

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1 WH-1404, Rev. Feb 97

2 Page No. i REVISIONS REPORT NO. T56737 DATE December 20, 2011 REV DATE PAGE OR PARAGRAPH AFFECTED BY APP'L DESCRIPTION OF CHANGES A 12/16/11 Cover Page Changed total of pages and title. A 12/16/11 TOC-1 of 1 Updated Attachment H. A 12/16/11 Page No. 1 of Scope Added second paragraph. A 12/16/11 Page No. 1 of Product Description Revised. A 12/16/11 Page No. 2 of Compliance Summary Revised first paragraph.

3 Page No. ii A 12/16/11 Page No. 2 of Details of Test System Revised Table 2-1 Components List A 12/16/11 Page No. 3 of Construction Details Revised first paragraph. A 12/16/11 Page No. 3 of Construction Details Table 2-2 Load Ratings A 12/16/11 Page No. A-2 of 4 through A-4 of 4 Revised titles of Photograph Nos. 1 and 6. A 12/16/11 Page No. G-1 of 7 ATTACHMENT G Changed title page and updated specification sheets. A 12/16/11 Page No. H-1 of 20 ATTACHMENT H Updated attachment contents.

4 Page No. TOC-1 of 1 TABLE OF CONTENTS Page No. 1.0 INTRODUCTION Scope Product Description References Compliance Summary SYSTEM TEST CONFIGURATION Details of Tested System Electrical Construction Details Quality Assurance Test Equipment and Instrumentation...3 ATTACHMENTS ATTACHMENT A PHOTOGRAPHS...A-1 ATTACHMENT B SAFETY CRITICAL COMPONENTS...B-1 ATTACHMENT C TEST DATA...C-1 ATTACHMENT D INSTRUMENTATION EQUIPMENT SHEET...D-1 ATTACHMENT E UL 746C TEST REPORT...E-1 ATTACHMENT F AMERICANS WITH DISABILITIES ACT ACCESSIBILITY GUIDELINES F-1 ATTACHMENT G PATRIOT PORTABLE PRO LIFT SPECIFICATIONS...G-1 ATTACHMENT H INSTALLATION AND OPERATING INSTRUCTIONS... H-1 A

5 Page No. 1 of INTRODUCTION 1.1 Scope This report documents conformance of the Aqua Creek Products Model F-12PPL-HD Patriot Portable Pro Pool Lift with the applicable requirements of the American with Disabilities Act (ADA): 1990 (Amendments Act of 2008): Accessibility Guidelines , ANSI/AAMI ES :2005 "Medical Electrical Equipment Part 1: General Requirements for Basic Safety and Essential Performance", and Clause 27 of the "Standard for Polymeric Materials" UL 746C. Testing and evaluation of the Patriot Portable Pro Pool Lift was conducted at Wyle Laboratories facility in Huntsvile, AL and Aqua Creek Products facility in Missoula, MT. The testing and evaluation was authorized by Mr. Brian Goettlich of Aqua Creek Products and conducted during July 7-10, This report also includes two (2) optional models: 1) Patriot AC Portable F-12PPL-TSA and 2) Rebel Portable F-2PR. These models are modified versions of the Patriot Portable Pro Pool Lift as described in Section 2.1 of this report. A Contact: Mr. Brian Goettlich Telephone: (888) bgoettlich@aquacreek.com 1.2 Product Description The Patriot Portable Pro Pool Lift, Patriot AC Portable F-12PPL-TSA Pool Lift, and Rebel Portable F-2PR Pool Lift are 24-VDC battery-powered, self-operable, portable lifts designed to assist physically challenged individuals with access to swimming pools and/or spas. A A detailed description of the subject pool lifts, hereinafter referred to as the Equipment Under Test (EUT), and support equipment is provided in Section References Aqua Creek Products Purchase Order No Wyle Laboratories' Quotation No. HSV 545/048441/NB American with Disabilities Act: 1990 (Amendments Act Of 2008): Accessibility Guidelines ANSI/AAMI ES :2005, "Medical Electrical Equipment Part 1: General Requirements for Basic Safety and Essential Performance" (IEC :2005) UL 746C "Standard for Polymeric Materials" Wyle Laboratories Quality Asurance Program Manual, Revision 3 ANSI/NCSL Z540-1, "Calibration Laboratories and Measuring and Test Equipment, General Requirements" ISO , "Quality Assurance Requirements for Measuring Equipment"

6 Page No. 2 of Compliance Summary The subject pool lifts detailed in Section 1.2 above complied with the applicable requirements of ANSI/AAMI ES :2005 and ADA Guidelines as indicated in Table 1-1 with no modifications necessary. This evaluation report is valid for the Patriot Portable Pro Pool Lift, the Patriot AC Portable F-12PPL-TSA lift, and the Rebel Portable F-2PR lift. Any safety changes, revisions, or corrections made to the lifts after this evaluation shall be reevaluated, and a revised report shall be issued. A Test Description Table 1-1 Compliance Summary Requirements ANSI/AAMI ES Compliant/Non-Compliant General Tests Section 4 Compliant Accessible Parts Section 5.9 Compliant Equipment Identification Section 7 Compliant Protection Against Mechanical Hazards Maximum Temperature During Normal Use Section 8 Section 11 Compliant Compliant Test Description Requirements ADA Accessibility Guidelines Compliant/Non-Compliant ADA Requirements Compliant 2.0 SYSTEM TEST CONFIGURATION 2.1 Details of Tested System The EUT and associated components of the test system are identified in Table 2-1. Table 2-1 Components List * Item Part Number Quantity Battery/Control Combination CBJH Volt Battery BAJ 1 Control Box CBJ2 1 Battery Charger, Wall Mount CHJ2 1 Battery Charger, Plug-In CH08 1 Linak Actuator LA-34 1 Derock Actuator (2) YLSDTZ01 1 Handset, DIN Connector HB00-U017 1 Handset, RG11 Connector HB00-U038 1 A * See model specifications for specific components list.

7 Page No. 3 of Electrical Ratings Battery Charger 100/240 VAC, 50/60 Hz Battery 24 VDC, 6.5A 2.3 Construction Details Each of the pool lift frames are constructed of stainless steel coated with a UV resistant powder coat finish. For specific construction details see Attachments G and H. Approximate weight and measurements of the lifts are as follows: A Weight: 960 lbs. (including weights) Dimensions (Retracted Mode): 41 3/8 (105 cm) height x 50 5/8 (128.5 cm) deep x 53 5/8 (128.5 cm) wide Table 2-2 Load Ratings Model Load Capacity (lbs.) Static Load Capacity (lbs.) A Patriot Portable F-12PPL-HD Patriot AC Portable F-12PPL-TSA Rebel Portable F-2PR Quality Assurance All work performed on this program was in accordance with Wyle Laboratories' Quality Assurance Program and Wyle Laboratories Quality Program Manual, which conforms to the applicable portions of International Standard Organization (ISO) Guide The Wyle Laboratories,, Quality Management System is registered in compliance with the ISO-9001 International Quality Standard. Registration has been completed by Quality Management Institute (QMI), a Division of Canadian Standards Association (CSA). Wyle Laboratories is accredited (Certificate No ) by the American Association for Laboratory Accreditation (A2LA), and the results documented in this test report have been determined in accordance with Wyle s scope of accreditation unles otherwise stated in the report. 2.5 Test Equipment and Instrumentation All instrumentation, measuring, and test equipment used in the performance of this test program was calibrated in accordance with Wyle Laboratories' Quality Assurance Program which complies with the requirements of ANSI/NCSL Z540-1, ISO , and ISO/IEC Standards used in performing all calibrations are traceable to the National Institute of Standards and Technology (NIST) by report number and date. When no national standards exist, the standards are traceable to international standards or the basis for calibration is otherwise documented. Attachment D contains of the instrumentation, measuring, and test equipment that were used to perform the tests.

8 Page No. A-1 of 4 Test Report No.T

9 Page No. B-1 of 2 ATTACHMENT B SAFETY CRITICAL COMPONENTS

10 Page No. B-2 of 2

11 Page No. C-1 of 10 ATTACHMENT C TEST DATA

12 Page No. C-2 of 10

13 Page No. C-3 of 10

14 Page No. C-4 of 10

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17 Page No. C-7 of 10

18 Page No. C-8 of 10

19 Page No. C-9 of 10

20 Page No. C-10 of 10

21 Page No. F-11 of 4

22 Page No. G-1 of 7 ATTACHMENT G A PORTABLE LIFT SPECIFICATIONS

23 Page No. G-2 of 7 A

24 Page No. G-3 of 7 A

25 Page No. G-4 of 7 A

26 Page No. G-5 of 7 A

27 Page No. G-6 of 7 A

28 Page No. G-7 of 7 A

29 Page No. H-1 of 20

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