DANIEL 2500 - Page 159

DANIEL INDUSTRIES, INC.
CUSTOMER PROBLEM REPORT
FOR FASTEST SERVICE, COMPLETE THIS FORM, AND RETURN IT ALONG WITH THE AFFECTED
EQUIPMENT TO CUSTOMER SERVICE AT THE ADDRESS INDICATED BELOW.
COMPANY NAME:____________________________________________________________________________
TECHNICAL CONTACT:_________________________________ PHONE:______________________________
REPAIR P. O. #:_____________________________ IF WARRANTY, UNIT S/N:_________________________
INVOICE ADDRESS:____________________________________________________________________
_________________________________________________________________
_________________________________________________________________
SHIPPING ADDRESS:___________________________________________________________________
_________________________________________________________________
_________________________________________________________________
RETURN SHIPPING METHOD:__________________________________________________________________
EQUIPMENT MODEL #:____________________ S/N:__________________FAILURE DATE:_____________
DESCRIPTION OF PROBLEM:__________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
WHAT WAS HAPPENING AT TIME OF FAILURE?________________________________________________
______________________________________________________________________________________________
ADDITIONAL COMMENTS:____________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
REPORT PREPARED BY:________________________________ TITLE:________________________________
IF YOU REQUIRE TECHNICAL ASSISTANCE, PLEASE FAX OR WRITE THE MAIN CUSTOMER SERVICE
DEPARTMENT AT:
DANIEL MEASUREMENT AND CONTROL PHONE: (281) 897-2900
ATTN: CUSTOMER SERVICE FAX: (281) 897-2901
19203 HEMPSTEAD HIGHWAY
HOUSTON, TEXAS 77065