Field Report

* fields are compulsory

• Address Where Incident Occurred *
  
• Date of Problem *
  
• Part Number/Product Description *
  
• Product Manufacture Date *
  
• Description of Problem *
  
• Description of use/installation details
  
• Place of Purchase *
  
• Date of Purchase *
  
• Contractor *
  
• Contractor phone number *
  
• Contractor address
  
• City
  
• State
  ---AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY
• Zip Code
  
• Operating Temperature
  
• Operating Pressure
  
• Type of solvent/cement used
  
• Type and brand of pipe used
  
• What part of the product had the issue (where did it leak from or fail?) *
  
• When did the failure occur *
  ---product arrived defectiveduring installationduring testing (number of stories or PSI of pressure)post installationunknown
• If post installation- How long had the product been installed?
  
• Who found the issues and how was it first noticed?
  
• Is this the only product with which you have had the issue, or is it an issue that repeats itself?
  
• What was the water pressure or force on the product?
  
• Was there damage and if so, what was damaged?
  
• Pictures
  
  Maximum upload size: 20MB, File Format: jpg, jpeg, png, gif only
  Select multiple files with CTRL and Shift keys.
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