Palintest Service Report
Palintest 3/6 Calibration Report
Duffield Order Number
*
Facility Name
*
Date
*
-
Month
-
Day
Year
Date
Palintest Model
*
Palintest 3
Palintest 6
Palintest 9
Palintest 25
Serial Number
*
Palintest Service
Type of Service
*
Calibration
Repair
Error Message
*
NA
Error 5
Error 6
Error 7
Error 8
Error 9
Error 100
Error 101
Error 107
Error 110
Error 111
Instrument Condition
Instrument Upon Arrival
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Returned Unit
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Cleaning and Parts Used
Cleaning of Instrument
Parts Replaced
Palintest 3/6 Calibration
Set Code %T
Set Code %T
Set Code mg/l
Set Code mg/l
Set Code QC Tolerance +/-
Set Code QC Tolerance +/-
Palintest 9/25
Spectrum Readings
Spectrum Readings
Conclusion
Technician Name
*
First Name
Last Name
Technician Phone Number
*
-
Area Code
Phone Number
Billing
*
Complete
Follow Up Rqd
Technician Notes on Follow Up
Technician Signature
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Submit
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