• Aerosol Measurement
• Germicidal
• Ozone Column
• Photoallergy
• Photobiology
• Photostability
• Phototherapy
• Phototoxicity
• Radiometry
• UVCuring
• UVHazard

CALIBRATION & REPAIR REQUEST FORM

Date: ___________________

From: (Complete name and address)

Person name: _______________________________

Company name: _____________________________

Street Address: ______________________________

City: ________________________ State: ______________ Postal code: ________

Country: _________________________

Telephone: ______________________ FAX No. _____________________________

E-Mail: ______________________________

Payment Information:

Credit Card: MasterCard / Visa / Amex / Discover

Credit Card #____________________________________ Exp. ________________

PO # _____________________________

Service Requested : 

Repair: __________  Calibration: _________  Repair & Calibration: _________

72 hour Calibration: __________          

Other (explain below):

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

List the items and serial number being return:

1. Description:________________   Model Number:______  Serial Number:________

Describe Problem: ____________________________________________________

___________________________________________________________________

2. Description:________________   Model Number:______  Serial Number:________

Describe Problem: ____________________________________________________

___________________________________________________________________

3. Description:________________   Model Number:______  Serial Number:________

Describe Problem: ____________________________________________________

___________________________________________________________________

4. Description:________________   Model Number:______  Serial Number:________

Describe Problem: ____________________________________________________

___________________________________________________________________

Return Shipping Instruction:

Via: UPS:___________  FedEx:___________  Other:___________

Account #:____________________________________________

Ship to address: (Complete name and address)       Check if same as above _______

Person name: _______________________________

Company name: _____________________________

Street Address: ______________________________

City: ____________________ State: _________________ Postal code: _________

Country: _________________________

Telephone: ______________________ FAX No. _____________________________

E- Mail: _________________________________________

COMMENTS: __________________________________________________

___________________________________________________________________

___________________________________________________________________

____________________________________________________________

____________________________________________________________

Note: Please make copy of this completed form, fax copy to Solar Light Company,
Inc. Att. Sales: Fax No. 1 (215) 517-8747 and place copy in the box with the
instruments being return. *We use ICH code # 9027304040 and 9801100000 for our instruments. Please contact your customs broker and advise if you have another ICH code # for us to use for the return shipment.