ULTRA-VAC MODELS 6614D, 7614D,8614D
Warranty Registration Form & Inspection Report
WARRANTY REGISTRATION (3 part form - please print)
This form must be filled out by the dealer and signed by both the dealer and the customer at the time of delivery.
Delivery Date: mm / dd / yyyy
COMPANY / CUSTOMER NAME
DEALER NAME
Phone:
Phone:
Mobile phone:
Mobile phone:
Email : @
Email : @
Street Address:
Street Address:
City: Prov/State
City: Prov/State
Postal/Zip Country
Postal/Zip Country
Machine Serial Number
Blower #1 Serial No.
Blower #2 Serial No.
(if so equipped)
Airlock Serial Number
DEALER INSPECTION REPORT
SAFETY
Blowers and Airlock Turn Freely
Guards Installed and Secured
Boom Anchored in Place
All Safety Signs Installed
Check Tire Pressure
Reflectors and SMV Signs Clean
Hydraulic Hose Connections Tight
Review Operating and Safety Instructions
Hydraulic Hoses Free and Fitting
Engine Manual Supplied
Wheel Bolts Tight
Ultra-Vac Operating Manual Supplied
Lubricate Machine
Check Oil Level in Reservoirs
Belts are Tight
O-Rings in Place
I have thoroughly instructed the buyer on the above described equipment which review included the Operator’s
Manual content, equipment care, adjustments, safe operation and applicable warranty policy.
Date
____________________
Dealer's Rep. Signature
_________________________________________
The above equipment and Operator’s Manual have been received by me and I have been thoroughly instructed as to
care, adjustments, safe operation and applicable warranty policy.
Date
___________________
Owner's Signature
________________________________________
199 05042016
WHITE
YELLOW
PINK
3 Part Form
Please Print
WALINGA
DEALER
CUSTOMER
Содержание ULTRA-VAC 5614D
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