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SUPERDUTYVAC-OP-EN
BACKPACK VAC PM RECORDS
CUSTOMER INFORMATION
CUSTOMER
ADDRESS
PHONE
CITY
STATE
ZIP CODE
CONTACT
MACHINE INFORMATION
MODEL #:
SERIAL #:
WORK ORDER#:
BAG CONDITION
FILTER BAG
GOOD
WORN
NEEDS
REPLACEMENT
CLOTH BAG
GOOD
WORN
NEEDS
REPLACEMENT
CHECK OPERATION AND CONDITION OF:
IN SPEC
REPAIR
PROBLEM
POWER SWITCH
VACUUM MOTOR PERFORMANCE
VISUALLY INSPECT
IN SPEC
REPAIR
PROBLEM
VACUUM HOSES
FLOOR ATTACHMENTS (OPTIONAL)
MACHINE WHEELS (OPTIONAL)
COMMENTS
SERVICING DISTRIBUTOR: ____________________________________
TECHNICIAN’S NAME: ______________________________ DATE: _______________ SIGNATURE: ________________________
CUSTOMER’S NAME: _______________________________ DATE: _______________ SIGNATURE: ________________________
