Xerox 8830 - Page 472

Carrier inspection Discrepancy Report
THE DOCUMENT COMPANY
XEROX
Machine Serial Number
C.S.E. Name
Carrier Name
Part # Replaced (Missing / Broken)
Part # Replaced (Missing / Broken)
Kit Replaced (Missing / Broken)
Product Code
C.S.E. Emp. Number
Carrier Location
Part # Replaced (Missing / Broken)
Part # Replaced (Missing / Broken)
Kit Replaced (Missing / Broken)
Not Repairable Damage (Explain)
Machine Condition: • Excellent
• Good
• Fair • Poor
Comments:
Send to: Jim Samson- 11 Linden Park- Rochester. N.Y. - 14625 ( Email) JSAMS:Roch807:Xerox
9/19/96