Siemens 7SG164 Ohmega 400 Series Manual page 129

3 Defect Report Form
Form sheet for repairs and returned goods
S ender:
* Name, first name:
E mail address:
* Order-/ refere nce-no (choos ing at lea st 1 option):
Order-no fo r rep air:
Information conce rning the product and its use :
* Order C ode (M LFB):
* Custom er:
Cu sto mer origin al purchase o rd er num ber:
* Type of order (c hoos ing at leas t 1 option):
Re pair
Up grade / Mod ification to ...
Type of failure:
De vice or mo dule do es not sta rt up
S porad ic failu re
P erman ent f ailure
Re peat ed brea kd own
E rror desc ription:
Displa y m essa ge:
(use sepa ra ted she et fo r more info )
A ct ive LED m essa ges:
Fau lty Inte rf ace(s), wh ich?
*Detailed e rror desc ription (p le ase refer to othe r e rror rep orts or docum entat ion if possible):
* Shall a firmwa re update be made duri ng repair or me chanical upgrade of protective rela ys? (choosing at le ast 1 option)
Y es, to m ost recent versio n
repair report:
Y es, st anda rd report (free of charge )
S hippi ng a ddress of the repaired/upgraded produc t:
Co mpan y, depa rtm ent
Na me, f irst nam e
S treet, n umb er
P ostco de, city, co untry
Da te , Signature
Please contact the Siemens representative office in your country to obtain return instructions.
©2011 Siemens Protection Devices Limited
Co mplete pho ne nu mbe r (incl. co untry co de):
* Org-ID and GBK refere nc e:
o rd er-/ delivery n ote-no for return of comm issio n
fa ilure:
Firm ware version :
V
P roduct wa s in u se approximate ly since:
De live ry no te nu mbe r with position num ber:
Re turn o f co mm ission failure
W arranty repa ir
For colle ction
M echanical problem
Knock sensitive
Tem perat ure caused f ailure
Failure afte r firmwa re upd ate
W rong mea su re d valu e(s), wh ich?
No
Yes, det ailed re port (charge: 400EUR)
7SG164 Ohmega 400 Series Maintenance
(fields marked with * are mandatory fields)
C omp lete fax nu mber (incl. cou ntry cod e):
* AWV :
B eginning order-no fo r cred it n ote d ema nd:
* Seria l numbe r:
S tation /proje ct :
M anu facturer:
Hotline Inpu t no .:
Cre dit Note
Qu otation (n ot repa ir V 4 and curre nt
products! Se e price s in P MD)
Overlo ad
Tran sp ort dam age
Fa ilure af ter ca h rs in use
Fa ult y inpu t(s)/ou tput(s), which ?
Yes, actua l p arame ters must be reusable
Chapter 10 Page 6 of 6