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� nan <br />a��.r og :an <br />Address:' <br />. ISD Alarm Log City: <br />12 <br />p- <br />1/1 <br />1/r <br />1/151 <br />telTime <br />oblem <br />S <br />S—A�LI <br />Date/Time <br />Component <br />Removed. <br />Date/Time <br />Service Call <br />Date of <br />Technician Information <br />Name, Affiliation, Phone <br />Type of <br />Service <br />-- <br />Type of Service Performed and the <br />tected' <br />from <br />Made' <br />Service 4 <br />Number and Certification <br />(Repair or ISD <br />Outcome? <br />Service <br />Numbers <br />Alarm)6 <br />5t m � 3T f 5 <br />vn� <br />- 111 — - <br />- - ...---- - -- - <br />-- -- - - ---- - ....... <br />- - <br />--------- <br />- <br />t� <br />ane la r <br />r <br />`3 P' e512[ <br />V\Ap <br />Ih <br />--------------- <br />- -- ----- <br />L4 Inn U6c <br />77—T <br />lei <br />nu c� <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 />4Record date and time service was performed. <br />5Record 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 />7Record 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 />7 <br />