15 .
KABI Mobile Diesel Oil Tanks
Tab.5. Failure Notification Form
FAILURE NOTIFICATION FORM No.:
Date: ____________________
MAINTENANCE SERVICE ORDER
For:
KABI A/S
Kokkedalsvej 29
DK-2970 Hoersholm
Tel . +45 4576 0242
Fax +45 4576 4468
Mail: kabi@kabi .dk
Buyer/Customer CODE
Company/Name and Surname:
Address:
Contact person:
Tel.:
Tank location:
Proof of purchase No.
Company/Name and Surname:
(Invoice/Receipt)
Address:
Purchase Date:
Contact person:
Tel.:
TANK DESCRIPTION:
Serial No. (on a nameplate):
Warrant Card No.:
Tank type:
TT250 (250L)
TT425 (425L)
TT600 (600L)
Fuel type:
DIESEL
ADBLUE
Pump type:
KABI 12V DC
KABI 24V DC
KABI 230V AC
NOTIFICATION REASON/FAILURE DESCRIPTION:
Legible signature of the notifying person:
NOTE: If it turns out that the failure during the warranty period has been caused by improper conduct or installation of the
product, or the damage occurred after the warranty, then the technical service costs are debited to the Owner .
DECISION OF SERVICE DEPARTMENT:
Legible signature:
DESCRIPTION OF PERFORMED REPAIRS:
Legible signature:
Filled by KABI A/S .
