CERTISAFE™ TANK MIXER MANUAL
13
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Company name
Contact name
First name
Last name
Address
Street
City
State
ZIP code
Phone number
Primary
Alternate
Email address
Preferred method of
contact (circle one)
Phone Email
Purchase order
number
Additional product
information
Serial Number
Cord Length
Information for Repair Technician
Was this unit used in a chemical treatment or wastewater
application? (circle one)
Yes No
Additional notes
Kasco Marine
800 Deere Road
Prescott, WI 54021
Attn: Repairs
• Kasco requires that all equipment sent for repair MUST be
accompanied by this form and marked to Repairs attention.
• Unit should be cleaned before shipping.
• Kasco is NOT responsible for shipping damage accrued in
return shipment.
• It is the responsibility of the customer to ship and pay freight
to Kasco.
Note: Contact information should be that of the person or company to contact for repair information.
REPAIR CONTACT FORM
