Laserfiche WebLink
�N�| <br /> �� <br /> � FIELD SERVICE REPORT No. <br /> Page f ---- <br />/'+_+___________________ __�_. o _1 <br /> ___ + + <br /> ��___ _____________ _ _______________________________----- <br />| | | In-Warranty 1 | Out-of-Warranty (bill owner) | <br /> +________________-__..... --------------++_+____________________ <br />| CUSTOMER with address | AUTHORIZED SERVICE CEN---------------+ <br /> n <br />| Delta Convalescent Hospital | HK Biomeqix / �� | <br /> | <br />| 1334 S. Ham Lane P. O. Box �--1 <br />' Lpdi , CA 95242 � | North Highlands, Ca. � <br /> � 95660-0581 (916) 348-8832 � <br />'____________________________+________+______+__L=_______+_________+_________+ <br /> SERVICE REQUESTED BY | SERVICE REQUEST / MFG. ) MODEL # '1 SERIAL # | � <br /> NAME ! DATE 1-12-88 +�..........+---------+----_____+ ' <br /> ORGANIZ. +---_ ................_ ------+Pelton | | | <br /> PHONE : COMPLETION | Crane 1 OCR 1 A4-4670 | <br /> ----------------------------+DATE 1-13-88 � / ( | | <br /> PURCH. ORDER NO. +---------+-----+-----------+---------+---------+ <br /> Verbal 1 OBSERVED: Mineral deposit build up oW <br />--�----------------.....-------------------+ door gasket surface. � <br /> COMPLAINT/REQUEST: Leaking | <br /> � <br /> . � | <br /> / | <br />--------------------------------------+-------+---------+-------+-----------+ <br /> SERVICEPERFORMED: Remove accumulated mineral ! Date | Labor 1 Travel | <br /> build up. Cy'cled to test for leaks. Verified | l (Hours) | Hours Miles | <br /> calibration of front panel indicators (Temp. +---------+-------+-----+-----+ <br /> and pressure) . | 1-13-88 | 1 | 2 | 90 | <br /> +_________+_______+_____+_____+ <br /> +_________+_______+_____+_____+ <br /> ^ | | | | | <br /> ` +_________+_______+_____+_____+ <br /> | | | | | <br />-____________+_____-___________-________+_____+________++__+____+__+__+_____+ <br /> PART NO. | DESCRIPTION | SCH 1 DATE | QTY ( UNIT | TOTAL | <br /> | i SYM | | | PRICE ( PRICE | <br />-------------+--------------------------+-----+--------+___+-------+--------- <br /> | ) | | | | | <br /> _ <br />______ ______+__________________________+_____+___+____+___+_______+________+ <br /> REMARKS: Recommend distilled water - be used ! PARTS >> | | <br /> instead of plain bottled water which contains +----------------+-------_+ <br /> minerals. MRS LABOR>> | | <br /> +________________+________+ <br /> QALE8 TAX >> | | <br /> +________________+________+ <br /> | SHIPPING >> | | � <br /> +________________+________+ <br /> | OTHER >> | | <br /> +________________+________+ <br /> � | TOTAL COST >> ( � <br />--------------------------------------------------+----------------+________+ <br /> TRAVEL/EXCESS TIME AUTHORIZED BY: DATE | <br />______________________________ __ <br /> :Ij�gz ___________________________+ <br /> SERVICE ENGINEER SIGNATURE: Ab low-) �Y DATE <br />_-------- ---------------------__ -------------------------- <br /> ____+ <br /> orm FLDSEREP. FRM Ref . Inv. File No. CD00501 . FSR <br />