Flow Meter/Controller Return Form

	Fields marked in RED with a * are REQUIRED!
Customer Info	Name  * Phone  * Company Name * Email *
	Retype 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     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: