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Appendix A
A.1
SRF
– Service Request Form
Converter from Fieldbus to 4-20mA
GENERAL DATA
Model:
FI302 ( )
FI303 ( )
Serial Number:
_______________________________________________________________________________________________
TAG:
_______________________________________________________________________________________________
How many
channels are
used in IF?
1 ( )
2 ( )
3 ( )
Configuration:
Magnetic Tool ( )
PC ( ) Software: _____________
Version: _______________
Other: _______________
INSTALLATION DATA
Type/Model/Manufacturer of device
connected to the channel 1:
______________________________________________________________________________
______________________________________________________________________________________________________________
Type/Model/Manufacturer of device
connected to the channel
2:
______________________________________________________________________________
______________________________________________________________________________________________________________
Type/Model/Manufacturer of device
connected to the channel
3:
______________________________________________________________________________
______________________________________________________________________________________________________________
PROCESS DATA
Hazardous Area
Classification:
( ) Yes, please specify: _______________________________________________________________________
( ) No
More details: ________________________________________________________________________________
Types of Interference
presents in the area:
Without interference ( )
Temperature ( )
Vibration ( )
Others: ______________________________
Ambient
Temperature:
From __________ºC up to __________ºC
OCCURRENCE 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.
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