Service Form
Model No. ____________ Serial No. _______________ Date _________________
Name and Telephone No. _____________________________________________
Company _________________________________________________________________
List all control settings, describe problem and check boxes that apply to problem. _________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
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Intermittent
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Analog output follows display
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Particular range or function bad; specify
_______________________________
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IEEE failure
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Obvious problem on power-up
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Batteries and fuses are OK
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Front panel operational
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All ranges or functions are bad
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Checked all cables
Display or output (check one)
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Drifts
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Unable to zero
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Unstable
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Overload
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Will not read applied input
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Calibration only
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Certificate of calibration required
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Data required
(attach any additional sheets as necessary)
Show a block diagram of your measurement including all instruments connected (whether power is turned on or
not). Also, describe signal source.
Where is the measurement being performed? (factory, controlled laboratory, out-of-doors, etc.)_______________
__________________________________________________________________________________________
What power line voltage is used? ___________________ Ambient temperature? ________________________ °F
Relative humidity? __________________________________________ Other? __________________________
Any additional information. (If special modifications have been made by the user, please describe.)
__________________________________________________________________________________________
__________________________________________________________________________________________
Be sure to include your name and phone number on this service form.
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