Appendix B
B.1
SRF
– Service Request Form
FY Positioner
GENERAL DATA
Model:
FY290 ( ) Firmware Version: ______________________ FY301 ( ) Firmware Version: ______________________
FY302 ( )
Firmware Version: ______________________ FY303 ( ) Firmware Version: ______________________
FY400 ( ) Firmware Version: ______________________
Serial Number:
_______________________________________
Sensor Number:
________________________________________
TAG:
_______________________________________________________________________________________________
Remote
Position
Sensor?
Yes ( )
No ( )
Pressure
Sensor?
Yes ( )
No ( )
Action:
Rotary ( )
Linear ( )
Travel:
15 mm ( )
30 mm ( )
50 mm ( )
100 mm ( )
Other: ________ mm
Configuration:
Magnetic Tool ( )
Palm ( )
Psion ( )
PC ( )
Software: _________
Version: __________
FINAL CONTROL ELEMENT DATA
Type:
Valve + Actuator ( )
Pneumatic Cylinder (ACP) ( )
Other:________________________
Size:
_______________________________________________________________________________________________
Travel:
_______________________________________________________________________________________________
Manufacturer:
_______________________________________________________________________________________________
Model:
_______________________________________________________________________________________________
AIR SUPPLY
Conditions:
Dry and Clean ( )
Oil ( )
Water ( )
Other: ____________________________________
Work Pressure:
20 PSI ( )
60 PSI ( )
100 PSI ( )
Other: ________ PSI
PROCESS DATA
Hazardous Area
Calssification
Non-Classified ( )
Chemical ( )
Explosive ( )
Other: ________________________________
Interference
Types
Vibration ( )
Temperature ( )
Eletromagnetic ( )
Others:
_______________________________
SITUATION DESCRIPTION
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
SERVICE SUGGESTION
Adjustment ( )
Cleaning ( )
Preventive Maintenance ( )
Update / Up-grade ( )
Other: _________________________________________________________________________________________________________
USER INFORMATION
Company:
_____________________________________________________________________________________________________
Contact:
______________________________________________________________________________________________________
Title:
_________________________________________________________________________________________________________
Section:
______________________________________________________________________________________________________
Phone:
__________ _________________________ __________ _________________________
Extension:
____________________
E-mail:
_________________________________________________________________________
Date:
______/ ______/ __________
For warranty or non-warranty repair, please contact your representative.
Further information about address and contacts can be found on www.smar.com/contactus.asp.
Summary of Contents for FY301
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