L-737-3-E
97
REPAIR REQUEST SHEET
Company name
Address
Contact
Return (shipping)
Reason for repair (type
of order)
□Repair □Calibration □Replacement □ Return
□Others
Delivery date Date of installation
Date of failure
◆ Unless the statements below are fully documented, returned equipment will not be processed.
Equipment Sensor Unit Transmitter
Model
Serial No.
Connections
Power supply
Flange pressure rating
Process conditions
Process fluid name
(chemical formula)
Temperature
Pressure
Range change data □YES □No Initial serial No. □YES □No
Output (mA) Output (frequency)
Pressure input Pressure output
Sensor conditions
□Tube empty (no obstacles)
□Sensor empty (no obstacles)
□Tube clogged/contaminated
Type of cleaning material used for sensor unit
◆IMPORTANT
If the tube leaks, make sure that no process fluids remain in the housing. To provide a safe working
environment for our employees and engineers, this form must be filled in completely and accurately.
Unless accurate and precise information about the process fluids is given, returned equipment will
NOT be processed. Include your instructions and conditions accurately and in detail.
NOTE: To avoid misunderstanding, completely fill in this form.
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