Return of materials request – Emerson Process Management 430 DO User Manual

Page 21

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FROM:

RETURN

BILL TO:

_____________________________

_____________________________

_____________________________

_____________________________

_____________________________

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CUSTOMER/USER MUST SUBMIT MATERIAL SAFETY SHEET (MSDS) OR COMPLETE STREAM COMPOSITION, AND/OR
LETTER CERTIFYING THE MATERIALS HAVE BEEN DISINFECTED AND/OR DETOXIFIED WHEN RETURNING ANY
PRODUCT, SAMPLE OR MATERIAL THAT HAVE BEEN EXPOSED TO OR USED IN AN ENVIRONMENT OR PROCESS THAT
CONTAINS A HAZARDOUS MATERIAL ANY OF THE ABOVE THAT IS SUBMITTED TO ROSEMOUNT ANALYTICAL WITH-
OUT 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.

SENSOR OR CIRCUIT BOARD ONLY:
(Please reference where from in MODEL / SER. NO. Column)

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. ________________

PLEASE CHECK ONE:

n

REPAIR AND CALIBRATE

n

DEMO EQUIPMENT NO. __________________________

n

EVALUATION

n

OTHER (EXPLAIN) _______________________________

n

REPLACEMENT REQUIRED?

n

YES

n

NO

_________________________________________________

DESCRIPTION OF MALFUNCTION:

______________________________________________________________________________________________________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

WARRANTY REPAIR REQUESTED:

n

YES-REFERENCE ORIGINAL ROSEMOUNT ANALYTICAL ORDER NO. ________________________________________

CUSTOMER PURCHASE ORDER NO. _________________________________________________

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NO-PROCEED WITH REPAIRS-INVOICE AGAINST P.O. NO. _________________________________________________

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NO-CONTACT WITH ESTIMATE OF REPAIR CHARGES: LETTER

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__________________________________________

PHONE

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___________________________________________

NAME ____________________________________________________

PHONE _________________________________________

ADDRESS ___________________________________________________________________________________________________

______________________________________________________________

ZIP _________________________________________

RETURN AUTHORITY FOR CREDIT ADJUSTMENT [Please check appropriate box(s)]

n

WRONG PART RECEIVED

n

REPLACEMENT RECEIVED

n

DUPLICATE SHIPMENT

REFERENCE ROSEMOUNT ANALYTICAL SALES ORDER NO. _________

n

RETURN FOR CREDIT

RETURN AUTHORIZED BY: ______________________________________

WARRANTY DEFECT____________________________________________________________________________________

_____________________________________________________________________________________________________

24-6047

RETURN OF MATERIALS REQUEST

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This form must be completed to ensure expedient factory service.

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Emerson Process Management
Rosemount Analytical Inc.

2400 Barranca Parkway
Irvine, CA 92606 USA
Tel: (949) 757-8500
Fax: (949) 474-7250

http://www.RAuniloc.com

© Rosemount Analytical Inc. 2001

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