SMAR IF302 - Page 45

Appendix B
B.1
SRF – Service Request Form
Converter from 4-20mA to Fieldbus
GENERAL DATA
Model: IF302 ( ) IF303 ( )
Serial Number: _______________________________________________________________________________________________________
TAG: _______________________________________________________________________________________________________
How many
channels are
used in IF?
1 ( ) 2 ( ) 3 ( )
Configuration: Magnetic Tool ( ) PC ( ) Software: _____________ Version: _______________________
INSTALLATION DATA
Type/Model/Manufacturer of device
connected to the channel 1:
_______________________________________________________________________________________
Type/Model/Manufacturer of device
connected to the channel
2:
_______________________________________________________________________________________
_
Type/Model/Manufacturer of device
connected to the channel
3: _______________________________________________________________________________________
PROCESS DATA
Hazardous Area
Classification:
( ) Yes, please specify: _______________________________________________________________________________
( ) No
More details: ________________________________________________________________________________________
Types of Interference
presents in the area:
Without interference ( ) Temperature ( ) Vibration ( ) Others: _____________________________________
Ambient
Temperature:
From __________ºC up to __________ºC
OCCURRENCE 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.