WARRANTY REPAIR        REPAIR ORDER
Rejection or discrepancy Reports             copy attached  
  not available
 IDENTIFICATION 
Customer  
Purchase order No         
Plant       
Name of person to contact      
Instrument Tag No           
Model                   
Serial Number 
 
 OPERATING CONDITIONS 
Specify location, environmental conditions, type of service and approximate number of operating hours or 
date of installation if known 
 REASON FOR RETURN 
DANGEROUS FLUIDS
In case of toxic or otherwise dangerous fluid, please attach the relevant Material Safety Data Sheet 
Trouble found during. Installation 
 Commissioning               Maintenance   
At start up 
 On service  
Date   Signature       Originator
ABB Inc. 
Process Automation Division 
7051 Industrial Boulevard 
Bartlesville, Oklahoma 74006, USA   
Tel: +1 918 338 4888 
Fax: +1 918 338 4699