EQUIPMENT INCIDENT REPORT
Please enter as much information as you can. Send the completed form, together with the item for repair to your nearest authorized service
agent. NOTE: Only one fault to be recorded per form.
For further information contact the Powerware DC Product Services Division
Telephone:++64 3 343 3314 or Fax: ++64 3 343 7446.
Date: ...........................
Customer Information
Company: .....................................................................................................................................
Postal Address: ....................................................................................................................................
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Return Address (Not PO Box): .............................................................................................................
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Telephone: | Facsimile: | ........................... |
Contact Name: |
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Location of Failure |
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Product code | Serial number | Document No |
System type installed in | Serial number | |
Site name or location |
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Fault discovered |
| Delivery |
| Unpacking |
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| Initial test |
| Operation after |
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Failure source |
| Design |
| Manufacturing |
| Documentation |
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| Transportation |
| Installation |
| Handling |
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Effect on system operation
None
Minor
Major
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INFORMATION (fault details, circumstances, consequences, actions)
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Internal use only. |
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Reference No: | RMA: | NCR: | Signature: | Date: |
