Flow Meter/Controller Return Form
Fields marked in
RED
with a
*
are REQUIRED!
Customer Info
Name
*
Phone
*
Company Name
*
Email
*
Manufacturer
*
Model #
*
Serial #
Process Gas
*
Flow Range
*
slpm
sccm
slpm / sccm
Inlet Pressure
*
psig
psia
psig / psia
Outlet Pressure
*
psig
psia
psig / psia
Standard Temperature
and Pressure (STP)
*
(
NOTE:
If not defined will use 21.11° C and 101.325 kPa)
1.
21.11°C (70°F) / 101.325 kPa
2.
0°C / 101.325 kPa
3.
25°C / 101.325 kPa
4.
User Defined STP:
°
C
F
°C / °F
kPa
mmHga
psig
psia
Mounting Position
*
Horizontal (H)
Vertical, Inlet Up (VIU)
Horizontal, Either Side Down (HESD)
Vertical, Inlet Down (VID)
Horizontal, Upside Down (HUD)
Reason for Return
*
Re-Calibration Only (As Left Only)
Re-Calibration Only with As Found (If applicable / possible)
Clean, Minor Repair, Re-Calibration (As Left Only)
Clean, Minor Repair, Re-Calibration with As Found (If applicable / possible)
Description of problem or work to be performed: