Model No.
Name and Telephone No.
Company
List all control settings, describe problem and check boxes that apply to problem.
❏
Intermittent
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IEEE failure
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Front panel operational
Display or output (check one)
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Drifts
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Unstable
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Overload
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Calibration only
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Data required
(attach any additional sheets as necessary)
Show a block diagram of your measurement system 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?
Relative humidity?
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.
Serial No.
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Analog output follows display
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Obvious problem on power-up
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All ranges or functions are bad
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Unable to zero
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Will not read applied input
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Certificate of calibration required
Other?
Service Form
Date
❏
Particular range or function bad; specify
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Batteries and fuses are OK
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Checked all cables
Ambient temperature?°F
12/06