EQUIPMENT DISPOSITION NOTICE

Customer Name: KOM Date: 2/7/2023

Equipment Information:
Description DIGIMATIC CALIPER
Cal I.D : 0006152
Manufacturer : MITUTOYO Model: 573-634 Asset No : NA
Serial No : 0006152

Equipment Condition: Customer Disposition:

X FAILED (Specify Ranges with Failed Results) Issue Calibration Report - Failed Data
(Attached Failed Data Results if with this nothice for customer verification) Issue Calibration Report - Report of Value
See attached data.

Issue Calibration Report – Limited use

Perform Adjustment
MPC to Evaluate and Repair
(A minimum fee will charged as cost of Repair/ Evaluation and shall be waive once the unit
RECOMMENDATION: was endorsed to MPC for Repair)

Unit will be RETURNED AS IS

Others___________________________________

OUT OF TOLERANCE ( Calibration Cycle may be change)

DEFECTIVE (Specify Equipment Defect) Issue Calibration Report – Limited parameter use

MPC to Evaluate and Repair

(A minimum fee will charged as cost of Repair/ Evaluation and shall be waive once the unit
was endorsed to MPC for Repair)

RECOMMENDATION: Unit will be RETURNED AS IS

Others___________________________________

LIMITED USE (Specify Ranges wherein UUT cannot be used) Issue Calibration Report – Limited Use (as received condition)
Issue Calibration Report - Report of Value
MPC to Evaluate and Repair

RECOMMENDATION: (A minimum fee will charged as cost of Repair/ Evaluation and shall be waive once the unit
was endorsed to MPC for Repair)

Unit will be RETURNED AS IS

Others___________________________________

OTHERS MPC to REPLACE

Unit will be RETURNED AS IS

MPC to Evaluate and Repair

RECOMMENDATION:
Others___________________________________

NAME SIGNATURE CUSTOMER APPROVAL:

VERIFIED BY
CALIBRATION TECHNICIAN: CHU HUY DU DU

VERIFIED BY ( NAME and SIGNATURE )

REPAIR TECHNICIAN: