“
SAS Super IAQ” Rev. 1 Pg.
34
ENGLISH
To the attention of: Technical department International PBI S.p.A.
Via Novara, 89 - 20153 - Milano - Tel + 39 02/48.779.1-Fax +39 02/400.900.10
AUTHORIZATION RETURN NUMBER TO BE ASKED TO THE EXPORT DPT
Company:
Address:
City: Zip
Code
State
Phone Fax
Name to contact:
Lab/Division:
return
request of technical service
Equipment:
Model Serial
Number:
for
calibration
repair
other (specify)
NOTE OF MALFUNCTIONING
ELECTRONICAL PART
MECHANICAL PART
NOTES:
ATTENTION: THE INSTRUMENT MUST BE SENT TO
INT.PBI C/O STATIM VIA SAN GIUSTO 85 20153 MILANO ITALY
SIGNATURE NAME
DATE
Mod.
PQ09.9