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Model No.
Name and Telephone No.
Company
List all control settings, describe problem and check boxes that apply to problem.
Intermittent
Particular range or function bad; specify:
IEEE failure
Batteries and fuses are OK
All ranges or functions are bad
Display or output (check one)
Drifts
Unstable
Overload
Calibration certificiate 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, outdoors)?
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
Service Form
Serial No.
Analog output follows display
Obvious problem on power-up
Front panel operational
Checked all cables
Unable to zero
Will not read applied input
Calibration only
Data required
Ambient temperature:
Other:
Date
.
°F
23
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