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FEEDBACK FORM
DEFECTIVE EQUIPMENT HANDLING FORM
From:
Company:
Ref. no.:
Date:
EQUIPMENT INFORMATION
Instrument Type:
Serial number:
The equipment has been returned to the supplier cleaned and disinfected.
EQUIPMENT HISTORY
Unit arrived visibly damaged
Unit did not work when first put into operation
Unit broke down during installation
Unit worked for/since:
(period / time)
Unit has already been repaired before at
SBEM PVT LTD
FAILURE OBSERVATION
Incorrect function obtained during bench test
Incorrect function obtained at the application
TANK/SILO DATA
Height:
Diameter:
Measuring range
Min.:
Max.:
Open tank/silo
Closed tank/silo
Indoors
Outdoors
Underground
Metal tank/silo
Plastic tank/silo
Concrete silo
PROCESS CONDITIONS
Pressure:
Temperature:
Fixtures
Agitator/stirrer
Dust
Vapour/fume
Light foam:
mm
Heavy foam:
mm
Moderate waves
Strong waves
FILLING PROCESS
Gravity
Pneumatic
Above the top
From the side
MEASURED MATERIAL
OBSERVATIONS / DESCRIPTION OF FAULT / MALFUNCTIONING
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