Service Form
Model No. ___________________________ Serial No. _____________ Date__________
Name and Telephone No. ________________________________________________________
Company ______________________________________________________________________
List all control settings, describe problem and check boxes that apply to problem. _________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
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Intermittent
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Analog output follows display
❑
Particular range or function bad; specify
_______________________________
❑
IEEE failure
❑
Obvious problem on power-up
❑
Batteries and fuses are OK
❑
Front panel operational
❑
All ranges or functions are bad
❑
Checked all cables
Display or output (check one)
❑
Drifts
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Unable to zero
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Unstable
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Overload
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Will not read applied input
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Calibration only
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Certificate of calibration required
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Data required
(attach any additional sheets as necessary)
Show a block diagram of your measurement including all instruments connected (whether power is turned on or
not). Also, describe signal source.
Where is the measurement being performed? (factory, controlled laboratory, out-of-doors, etc.)_______________
__________________________________________________________________________________________
What power line voltage is used?___________________ Ambient temperature? ________________________°F
Relative humidity? ___________________________________________Other? __________________________
Any additional information. (If special modifications have been made by the user, please describe.)
__________________________________________________________________________________________
__________________________________________________________________________________________
Be sure to include your name and phone number on this service form.
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