Powerex - Warranty Card

To submit your warranty information, please

Fill in each selection below, then press the submit button when completed

" * " = required Information.

	Customer Information		Installer Information
* Customer Name:		Installer Name:
* City:		City:
* State/Province:		State/Province:
* Contact Name:		Contact Name:
Phone:		Phone:
Email:		Email:
	Product Information
* Model Number:		* Application:
* Serial Number:		Equipment this unit is supplying Air/Vacuum to:
* Startup Date:
	Environment		Ventilation
Humidity:		Climate Controlled:
Max Ambient Temperature:		Ventilated:
Min Ambient Temperature:
	Electrical
Incoming Voltage:		Phase:
Frequency:
	Pressure / Vacuum
Pump1 on:		Pump1 off:
Pump2 on:		Pump1 off:
Pump3 on:		Pump3 off:
Pump4 on:		Pump4 off:
Is the Operating Sequence Functioning Properly?:		Is the Hour Meter running properly??:
Are the Power and Run lights operational?		Comments or issues not addressed?