Complaint – Pipe system - Additional information

Dear customer,
You have announced a complaint on a fitting or a part of a piping system.
It is important and an absolute prerequisite that we get this additional information for us to make an accurate assessment of the complaint and give you the best feedback.

Please complete the form below as good as possible and please contact us if anything is unclear.

Date:	Click here to enter a date.
Purchase Date:	Click here to enter a date.
Your reference:
Your order number.
Customer (invoiced): If other than above.
Contact person:
Phone:
e-mail:

Description of the complaint:

Additional information:

Item number:
Prod. description:
Dimension:
Serie- or part number:
Quantity:

Material : Other: Insulated pipie:

Gasket: Other:

Date installation: Click here to enter a date.Date initial operation: Click here to enter a date.

Medium in contact with product: Concentration: %

Working pressure (bar) max/min: / bar

Testing pressure: bar Pressure fluctuations:

Working temp.: °C Ambient temp.: °C

Operation day per 24h:

Welding machine, type: Welding machine, no.:

Replace material requested: Ja: Nej: Subsequent damage: Ja: Nej:

Subsequent damage value: