Application
Model
Serial No.
Purchase date
Customer
Address
Contact
Tel
1. Maintenance/overhaul
□
Regular maintenance
□
Breakdown:
□
Ultimate pressure insufficient
□
Abnormal noise
□
Abnormal motion
□
Oil
leakage
□
Others
Description
：
□
Others
：
2
service condition
Used or not
：□
YES
□
NO
Utility time
： □
24hr service
□
Interval service
Contaminate or not
：
□
YES
□
NO
Product name and chemical name of the contaminant
：
Types and characteristic of the contaminant
：
Cleaning solvent and method of contaminant:
3
Content:
□
Warranty
□
Paid
□
Others
4
Other terms
：
Assignment of applicant
Date
