Calibration Request | Com-Power Corporation

Preamplifier Calibration Request Form

SECTION A -CUSTOMER/RETURN SHIPPING INFORMATION

Company Name:

Purchase Order #:

Address:

City:

State:

Zip:

TECHNICAL CONTACT

Name:

E-mail:

Phone Number:

Fax:

PURCHASING CONTACT

Name:

E-mail:

Phone Number:

Fax:

RETURN SHIPPING INFORMATION

Ship to (name):

E-mail:

Address:

City:

State:

Zip:

Shipping Company:

Customer Account Number:

Shipping Method:

Special Instructions:

SECTION B -PREAMPLIFIER INFORMATION

Manufacturer:

Model:

S/N:

Preamplifier is a Com-Powermodel and standard calibration service is requested, as defined in Table 1 below.

Calibration Interval:

TABLE 1 -STANDARD CALIBRATION SERVICES

Table

Preamplifier was previously calibrated by Com-Power; please provide the same calibration services as previously provided.

SECTION C -CALIBRATION INFORMATION

Frequency Range of Preamplifier Gain Calibration:

Start Frequency:

Stop Frequency:

*Special Instructions (i.e.: decision rule, test procedure deviations, etc.):

*Unless otherwise specified, measurement uncertainty will not be taken into account in the determination of compliance with applicable limits.

Customer Approval Signature:

Date:

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