Nor-Cal N-Series Op Lit - Manual (Page 16)

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Visit our Web Site www.n-c.com
N-Series Isolation Poppet Valves
www.n-c.com
1967 South Oregon Street, Yreka, California 96097
800-824-4166 • 530-842-4457 • FAX: 530-842-9130
RMA #
It is mandatory to obtain an RMA from Nor-Cal Products before returning any parts, items or materials. Complete the requested information in the Sections
below and fax this form to Nor-Cal Products, attention RMA Coordinator at fax# 866-640-9012 or 530-842-9130.
Section A Customer Contact Information
Company Name
Contact Name
Telephone
e-mail address
Original P.O.# Sales Order #
Section B Item to be returned
*NOTE: If part is NEW (never been used) and still in the original Nor-Cal packaging, check the box in the New column, skip Section C PCDS, and sign and date
Section D. If part has been removed from the original packaging, do NOT check the NEW box; continue to Sections C and D.
Part Number Serial Number Quantity New? PCDS
Reason for Return
Do you need a replacement for this part? (Include replacement P/N, if known)
Section C
Product Contamination Data Sheet
Type of process
Chemical exposure history
Cleaning performed
Describe any expected residues on returned part
*NOTE: IF TWO PARTS WITH OR WITHOUT THE SAME MODEL NUMBER HAVE BEEN EXPOSED TO DIFFERENT CHEMICALS THEY MUST BE LISTED ON SEPARATE
SHEETS. MAKE DUPLICATE COPIES OF THIS FORM AS NEEDED.
Section D Legally Binding Declaration
I represent that the information in this declaration is correct and complete to the best of my knowledge. I, the undersigned, have sufficient knowledge
regarding the condition of the product to complete this form. I am aware of the potential liabilities for damages and undertake to be responsible for such
damages to the extent that the damages are caused by incomplete or inaccurate information on this form. I certify that I have provided accurate information
to Nor-Cal Products or its Representatives and understand that any discrepancy between the information that I have provided and the part returned under
the RMA may cause the RMA to be revoked and the part returned to me at my expense.
Signature Date
Section E TO BE COMPLETED BY NOR-CAL PRODUCTS
Date reviewed
Determination
RMA # assigned
Rework/Repair Instructions
Welding Allowed? Yes o
No o Eval. o
Cleaning Allowed? IPA o H
2
O Descale Chem Clean EP
Signature MSDS Review
Signature
Repair Technician
Repair Date
I have reviewed the PCDS and corresponting MSDS’s.
aND
I understand how to safely handle these parts that may contain the
following contaminants
Signature
Date
Your RMA is: Your shipment is authorized Shipper &
______________________________________ for freight collect (Y/N) ____________ account: ___________________________________
Please return goods to: Nor-Cal Products Inc., 1967 South Oregon Street, Yreka, CA 96097
Return Material Authorization