Equipment Repair Form
Customer Company Name
Customer Contact Name
Customer Contact Phone
Customer Contact Email
Customer Order Number
Allied Pumps Contact Name
Allied Pumps Req Number
Allied Pumps Invoice Date
Allied Pumps Invoice Number
Pump Serial Number
Is this repair being claimed as Warranty? (Yes or No)
Installation Type - Details
Incoming Site Voltage Balanced and Stable
Starter Type - Details
What is the current overload set to?
Pump Rotate Freely
If Other, please provide details
Perform megger test on DI (Set Tester @ 1.0kv accept ≥ 5M Ohm) 0Ω
Other Observations/Reported Defects
ACTUAL OPERATING CONDITIONS
Ambient Temperature (°C)
Please tick the box below and enter your email address.
Once you have received a copy of the completed form, please attach a copy of the form to the item to be repaired.
Thank you and kind regards
Allied Pumps Service Department
Send me a copy of my responses
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