Return authorization request – Fluid Components International FLT93 Nuclear User Manual
Page 55

FLT
®
Series FlexSwitch
TM
APPENDIX D - CUSTOMER SERVICE
Fluid Components International LLC
55
1. Return Customer Information
Returning Company’s Name: _____________________________ Phone# __________________________________
Return Contact Name: __________________________________ Fax # ____________________________________
Address:
________________________________________________________________________________
2. Return Address
Bill To: _______________________________________ Ship To: _______________________________________
____________________________________________
______________________________________________
____________________________________________
______________________________________________
____________________________________________
______________________________________________
3. Mandatory End User Information
C
ontact: ______________________ Company: _____________________________ Country: ________________
4. Return Product Information
Model No: ____________________________________ Serial No(s): ____________________________________
Failure
Symptoms
(Detailed Description Required)
: ____________________________________________________
____________________________________________________________________________________________
What Trouble Shooting Was Done Via Phone or Field Visit by FCI: _________________________________________
____________________________________________________________________________________________
FCI Factory Technical Service Contact: _____________________________________________________________
5. Reason For Return
Sensor Element
Electronics
As Found Testing
Credit
Recalibrate (New Data)
Recalibrate (Most Recent Data)
Other
(Note: A new Application Data Sheet (ADS) must be submitted for all recalibrations and re-certifi cations)
6. Payment
Via
Faxed Purchase Order
(Note: A priced quotation is provided for all Non-Warranty repairs after equipment has been evaluated. All Non-Warranty repairs
are subject to a minimum evaluation charge of $250.00)
Factory Return Shipping Address:
Fluid Components International LLC
1755 La Costa Meadows Drive
San Marcos, CA 92078-5115
Attn: Repair Department
RA
#____________
RA #______________
1755 La Costa Meadows Drive, San Marcos, CA 92078-5115 USA
760-744-6950 / 800-854-1993 / Fax: 760-736-6250
Web Site: www.fluidcomponents.com
E-mail: techsupport@fl uidcomponents.com
Return Authorization Request