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t , <br />r �•I r r' 1 ,. ,, t.M r, it <br />ISD DAlarm Log <br />Site Name. t ' 3 C4 �1- <br />Address: _ <br />City:�Uo'© t T <br />DateMme <br />Problem <br />DateMme <br />Component <br />Removed <br />Datem me <br />Service Call <br />Date of <br />Technician Information <br />Name, Affiliation, Phone <br />Type of <br />Service <br />Type of Service Performed and the <br />Detected <br />from <br />MAade3 <br />Servlce4 <br />Number and Certification <br />Nu s <br />(Repair or ISD <br />Alarmf <br />outcome' <br />Service 2 <br />9 7 <br />/ <br />' 4? <br />•"? <br />J .F% ',T" t �rj �,L.' .a'G'i� f �t• <br />�y t q i. C:! 'moi-•�?vLd` <br />,.erg <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 />3Record 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 />7Record brief explanation of service performed, including outcome of service (repaired, tested and returned to service, waiting for parts, etc). Any all actions taken to <br />identify the cause of an ISD alarm, including the actual results of tests performed in accordance with the IOM requirements for that alarm (results may be <br />attached), must also be noted here or in supporting documents. <br />