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. _________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
q Intermittent q Analog output follows display q Particular range or function bad; specify
_______________________________
q IEEE failure q Obvious problem on power-up q Batteries and fuses are OK
q Front panel operational q All ranges or functions are bad q Checked all cables
Display or output (check one)
q Drifts q Unable to zero q Unstable
q Overload q Will not read applied input
q Calibration only q Certificate of calibration required q 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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