UNIQUE CONCEPTS
CONFINED SPACE ENTRY/RETRIEVAL TANK POD SYSTEM
WARRANTY REGISTRATION FORM & INSPECTION REPORT
WARRANTY REGISTRATION (please print)
This form must be filled out by the dealer and signed by both the dealer and the customer at the time of
delivery.
Customer’s Name________________________
Dealer Name________________________
Address________________________________
Address____________________________
City, State/Province, Code__________________
City, State/Province, Code______________
Phone Number ( ____ )____________________
Phone Number ( ____ )________________
Contact Name____________________________
Manufactured by: Unique Concepts Ltd.
1500 King Edward Street
Model __________________________________
Winnipeg, Manitoba, Canada
R3H 0R5
Serial Number ___________________________
Phone Number (204) 694-7432
Fax Number (204) 694-7612
Delivery Date ____________________________
Toll Free 1-800-455-9673
DEALER INSPECTION REPORT
___
All Appropriate Fasteners Torqued
___ Check that all fasteners and mechanical
components are present
___ Check Winch with Winch
Warranty Card
____ No Mechanical Damage
___ Check for finish damage
SAFETY
____ All Labels Installed Correctly and Legible
____ Review Operating and Safety Instructions
I have thoroughly instructed the buyer on the above described equipment which review included the
Operator’s Manual content, equipment care, adjustments, safe operation and applicable warranty policy.
Date ____________________ Dealer’s Rep. Signature _______________________
The above equipment and Operator’s Manual have been received by me and I have been thoroughly
instructed as to care, adjustments, safe operation and applicable warranty policy.
Date ___________________
Owner’s Signature ___________________________
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YELLOW
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UNIQUE CONCEPTS
DEALER
CUSTOMER
IV
