SMAR FY301 - Page 67

Appendix B
B.1
SRF – Service Request Form
FY Positioner
GENERAL DATA
Model:
FY290 ( ) Firmware Version: ______________________
FY301 ( ) Firmware Version: ______________________
FY302 ( ) Firmware Version: ______________________
FY303 ( ) Firmware Version: ______________________
FY400 ( ) Firmware Version: ______________________
Serial Number:
_______________________________________
Sensor Number:
________________________________________
TAG:
_______________________________________________________________________________________________
Remote
Position
Sensor?
Yes ( ) No ( )
Pressure
Sensor?
Yes ( ) No ( )
Action:
Rotary ( ) Linear ( )
Travel:
15 mm ( ) 30 mm ( ) 50 mm ( ) 100 mm ( ) Other: ________ mm
Configuration:
Magnetic Tool ( ) Palm ( ) Psion ( ) PC ( ) Software: _________ Version: __________
FINAL CONTROL ELEMENT DATA
Type:
Valve + Actuator ( ) Pneumatic Cylinder (ACP) ( ) Other:________________________
Size:
_______________________________________________________________________________________________
Travel:
_______________________________________________________________________________________________
Manufacturer:
_______________________________________________________________________________________________
Model:
_______________________________________________________________________________________________
AIR SUPPLY
Conditions:
Dry and Clean ( ) Oil ( ) Water ( ) Other: _________________________________
___
Work Pressure:
20 PSI ( ) 60 PSI ( ) 100 PSI ( ) Other: ________ PSI
PROCESS DATA
Hazardous Area
Calssification
Non-Classified ( ) Chemical ( ) Explosive ( ) Other: ________________________________
Interference
Types
Vibration ( ) Temperature ( ) Eletromagnetic ( ) Others: _______________________________
SITUATION DESCRIPTION
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
SERVICE SUGGESTION
Adjustment ( ) Cleaning ( ) Preventive Maintenance ( ) Update / Up-grade ( )
Other: _________________________________________________________________________________________________________
USER INFORMATION
Company: _____________________________________________________________________________________________________
Contact: ______________________________________________________________________________________________________
Title: _________________________________________________________________________________________________________
Section: ______________________________________________________________________________________________________
Phone: __________ _________________________ __________ _________________________ Extension:____________________
E-mail: _________________________________________________________________________ Date: ______/ ______/ __________
For warranty or non-warranty repair, please contact your representative.
Further information about address and contacts can be found on www.smar.com/contactus.asp.