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RETURN OF MATERIALS REQUEST
•IMPORTANT!
This form must be completed to ensure expedient factory service.
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| FROM: | RETURN |
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| BILL TO: | ||
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O | _____________________________ | _____________________________ | _____________________________ | |||||
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E | _____________________________ | _____________________________ | _____________________________ | |||||
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| CUSTOMER/USER MUST SUBMIT MATERIAL SAFETY SHEET (MSDS) OR COMPLETE STREAM COMPOSITION, AND/OR | ||||||
O | S LETTER CERTIFYING THE MATERIALS HAVE BEEN DISINFECTED AND/OR DETOXIFIED WHEN RETURNING ANY PROD- | |||||||
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E | UCT, SAMPLE OR MATERIAL THAT HAVE BEEN EXPOSED TO OR USED IN AN ENVIRONMENT OR PROCESS THAT CON- | |||||||
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C | D | TAINS A HAZARDOUS MATERIAL ANY OF THE ABOVE THAT IS SUBMITTED TO ROSEMOUNT ANALYTICAL WITHOUT | ||||||
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T | R THE MSDS WILL BE RETURNED TO SENDER C.O.D. FOR THE SAFETY AND HEALTH OF OUR EMPLOYEES. WE THANK | |||||||
| YOU IN ADVANCE FOR COMPLIANCE TO THIS SUBJECT. |
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SENSOR OR CIRCUIT BOARD ONLY: |
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(Please reference where from in MODEL / SER. NO. Column) |
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1. PART NO.__________________________1. | MODEL_________________________________1. | SER. NO. ________________ | ||||||
2. PART NO.__________________________2. | MODEL_________________________________2. | SER. NO. ________________ | ||||||
3. PART NO.__________________________3. | MODEL_________________________________3. | SER. NO. ________________ | ||||||
4. PART NO.__________________________4. | MODEL_________________________________4. | SER. NO. ________________ | ||||||
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| n REPAIR AND CALIBRATE |
| n DEMO EQUIPMENT NO. __________________________ | ||||
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| n EVALUATION |
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| n REPLACEMENT REQUIRED? n YES n NO | _________________________________________________ | |||||
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| DESCRIPTION OF MALFUNCTION: |
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| WARRANTY REPAIR REQUESTED: |
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| CUSTOMER PURCHASE ORDER NO. _________________________________________________ | ||||||
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| PHONE | n ___________________________________________ | ||||
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NAME ____________________________________________________ | PHONE _________________________________________ | |||||||
ADDRESS ___________________________________________________________________________________________________ | ||||||||
______________________________________________________________ | ZIP _________________________________________ | |||||||
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RETURN AUTHORITY FOR CREDIT ADJUSTMENT [Please check appropriate box(s)] |
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| n WRONG PART RECEIVED | n REPLACEMENT RECEIVED |
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| n DUPLICATE SHIPMENT | REFERENCE ROSEMOUNT ANALYTICAL SALES ORDER NO.__________ | |||||
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| n RETURN FOR CREDIT | RETURN AUTHORIZED BY: ______________________________________ | |||||
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| WARRANTY DEFECT____________________________________________________________________________________ | ||||||
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| _____________________________________________________________________________________________________ | ||||||
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Emerson Process Management |
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Rosemount Analytical Inc.
2400 Barranca Parkway
Irvine, CA 92606 USA
Tel: (949)
Fax: (949)
http://www.raihome.com
© Rosemount Analytical Inc. 2008