Check Sheet for Repair
Model
Serial
Purchase Date
Customers
Address
Person in charge
Tel No.
1 Request item
□
Scheduled inspection repairing
□
Trouble
Condition
：□
Ultimate pressure
□
Unusual sound
□
Irregular action
□
Oil leak outside the pump
□
Others
Description of trouble
：
□
Others
：
2 Service condition
Whether the pump has been used
：
□
Yes
□
No
Operational elapsed time
：
about
□
24hr continuous operation
□
Intermittent operation
Whether exposure to pollutants
：
□
Yes
□
No
Name and Chemical formula pollutants
：
Nature and character of pollutants
：
Cleaning solvents and methods of pollutants
：
3 Details of the request
□
Warranty period
□
Repair quote please
□
Others
：
4 Others
：
Signature
Date
Notice:
1
Copy this sheet use as repaired.
2
Your request for repair and inspection may be refused if this sheet is not included with the pump.
3
Information of hazardous gas in this sheet must be correct and sufficient.
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