Model Number |
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Serial Number |
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Date Installed |
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Installed By |
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Voltage Reading |
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End User |
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What is This Device Protecting? |
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Estimated Value of the Equipment Being Protected? |
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Estimated 24-Hour Downtime Cost if Equipment is Lost? |
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Device Mounted As Close As Possible To Connection Points: |
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Lead Conductors Cut As Short As Possible Without Straining or Creating Sharp Bends |
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Rate Ease Of Installation |
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Other Comments |
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