Brookeld Engineering Labs., Inc. Page 36 Manual No. M02-313E1209
IMPORTANT:
1. Brookfi eld recommends that all viscometers be returned for annual calibration.
2. Calibration & Certification Service is automatically performed for instruments that require torque sensing adjustments and/or
repair.
3. There is a $96.00 evaluation fee for repair estimates; this fee will be waived for instruments that receive service.
4. Requests for RUSH service must be indicated on the shipping package and accompanying paperwork.
5. We will contact you ONLY if repairs exceed $500.00.
ISO 9001:2000 CERTIFIED
BROOKFIELD
LABORATORY REPAIR RETURN FORM
CONTACT/USER INFORMATION (Please Print)
Primary Contact:______________________________________ Phone No. _____________________________________________________
Fax No.______________________________________________ Email:_________________________________________________________
BILLING: SHIPPING:
Company ___________________________________________ Company _____________________________________________________
Address _____________________________________________ Address ______________________________________________________
____________________________________________________ _____________________________________________________________
____________________________________________________ _____________________________________________________________
INSTRUMENT INFORMATION
Model: ______________________________ Please describe all problems/malfunctions: ________________________________________
Serial No: ____________________________ _____________________________________________________________________________
_____________________________________________________________________________
OPERATING CONDITIONS
Spindle: __________________ Speed: _________________ Viscosity Range:__________________ Temperature Control: _________________
Sample Temperature: _______________________________ Accessories: __________________________________________________________
SERVICE AND RETURN INSTRUCTIONS Please check service(s) required and describe problematic symptoms above.
❑
❑
Calibration & Ce
rtication Service > NOTE: this service is required for instruments that require torque sensing adjustments/repair
❑ CAP or QTS Service (please describe any problematic symptoms above)
❑ Cone Spindle Calibration (each spindle returned on Cone & Plate or CAP Viscometers)
❑ Ball Bearing Suspension Retrot* (Includes Calibration & Certication Service)
*Note (Available for DV-I+/Prime, DV-II+/PRO Viscometers, and DV-III+/Ultra Rheometers in torque ranges RV, HA, and HB)
❑ N.I.S.T. Traceability (includes copies of the certicates for all the reference equipment used to calibrate your equipment)
❑ 24 Hour Rush Service (not available for Cone & Plate or CAP Viscometers)
❑ 48 Hour Rush Service > NOTE: Rush Service will also increase above Cone Spindle Calibration Service
❑ Loan Instrument
If you return a Model D Helipath, Thermosel Container, or Thermosel Controller, these will be serviced as well
and each item will be billed on a separate invoice even if all items were sent together.
RETURN SHIPPING F.O.B. Middleboro, MA
UPS: ❑ Ground ❑ Next Day ❑ 2nd Day ❑ Collect** FEDERAL EXPRESS**: ❑ 2nd Day ❑ Standard Overnight ❑ Priority Overnight
(**Your account number is required for all Federal Express shipments and for UPS collect):______________________________________________
PAYMENT: Please note that we will only contact you if repairs exceed $400.00.
❑ Visa ❑ MasterCard ❑ American Express ❑ Purchase Order No. ___________________________________________
Name on Credit Card: __________________________________
Expiration Date _______________________________________
Account No. _________________________________________
Return Authorization No.
Please call our Repair Department for a Return Authorization Number, fill out this form
completely and return it with your instrument. Failure to do so will delay the repair process.
EZ-Loc Retrot
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