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Maii,inancoMep'ir 49 <br />iau .y�arm Avg <br />Date/Time <br />Problem <br />Detected' <br />DatelTime <br />Component <br />Removed. <br />from <br />Service2 <br />Date/Time Date of <br />Service Call <br />s Servicea <br />Made <br />Technician Information Type of <br />Name, Affiliation, Pho a Service <br />Number and Certification (Repair or ISD <br />s 6 <br />Number Alarm) <br />------- -- --- <br />Type of Service Performed and the <br />Outcome' <br />---------- - -- - - <br />A0103 <br />----- <br />............. _----------- <br />---- --- <br />-- ___.__.._... - ------ ----- - <br />--------------- -------------- - <br />— — -- ----- ---- -----•------ <br />11311q <br />AIS cu <br />u 0 <br />---- ---------- - — —�---------------- <br />— ---------- <br />- - - - <br />3 <br />- -- ---- --- -=- <br />- - - - -- -- - -- -- --- - - <br />- - <br />� f u <br />l <br />) <br />i ( <br />5VQ 5\,"WQ <br />M <br />'Record date and time the problem was detected. Include equipment defects or ISD alarms. <br />2Record date and time component was taken out of service, if applicable. <br />'Record date and time the service call was made. <br />°Record date and time service was performed. <br />SRecord certified repair technician's name, company affiliation, phone number and certification number from applicable manufacturer. <br />6Record the nature of the service call (repair or replace a component or respond to ISD alarm). Include ISD alarm type, if applicable. <br />'Record brief explanation of service performed, including outcome of service (repaired, tested and returned to service, waiting for parts, etc). Any and all actions <br />taken to identfy the cause of an ISD alarm, including the actual results of tests performed in accordance with the IOM requirements for that alarm (results <br />may be attached), must also be noted here or in supporting documents. <br />I <br />