MODOK Data

Form 6
Product Support

Malfunction / Damage Report

Duration of service:

Author:

No.:
/02

Date:

Page:
of

Country, City/Harbor

Engine Model

Engine No.

Operating
hours

Installation location
(e. g. port, stbd.)

Date of initial operation

Order No.

1
2
3
4
Description of installation (e. g. vessels name):

Designation of defective part / Model

Final customer (Country, City/Harbor)

Date of failure

Run time to
malf./failure

Description of defective part

Designation of defective part / Model

MTU No. of new part installed

Date of failure

Run time to
malf./failure

Description of defective part

Designation of defective part / Model

Description of defective part

Distribution:

MTU No. of defective part

MTU No. of new part installed

Date of failure

Run time to
malf./failure

Description of defective part

Designation of defective part / Model

MTU No. of defective part

MTU No. of defective part

MTU No. of new part installed

Date of failure

Run time to
malf./failure

MTU No. of defective part

MTU No. of new part installed

LPC-S

T-559-9902 (rev. 06-09-2002 JI)

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