Request for technical assistance

    Customer data

    First name

    Last name

    Business Name

    Address

    City (province)

    Nation

    Telephone

    Email

    Compressor installation location

    Hours and days available for the intervention

    Responsible/Reporter Mr.

    Cell. responsible

    Compressor data

    Model

    Serial number

    Year of construction

    Year of purchase

    Year first start-up

    Current operating hours

    Last maintenance performed (year)

    Hours of operation at last operation

    Performed by

    Description of the problem encountered

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