Parker Hannifin Corporation Hose Products Division 30240 Lakeland Boulevard Wickliffe, OH 44092 Phone: (440) 943-5700 Fax:

(440) 943-3129

QRL No. Date:

TECHNICAL PROBLEM CHECKLIST

INSTRUCTIONS:
Obtain a QRL Number (Q/C Report from Lab) from the Parker HPD Technical Service Department. After receipt, fill in the Technical Checklist as complete as possible. Obtain the components in question. For a hose analysis, include an unused three foot section of hose from the same reel or coil if available. For adapters or fittings, submit the items in question. Reference the QRL Number and put "Attention: Tech Service" on the outside of the shipping carton. Material sent with incomplete information will not be analyzed until adequate information is received.

End User: Address: Distributor/OEM: Address: Which Parker Salesman Calls on Your Account: Person to Contact: Fax: Was There an Injury or Property Damage? Part Number in Question: Description of Problem: Yes: Phone: Email: No: Qty :

Operating Conditions: Type of Equipment: Type of Fluid, Brand, and Number: Operating Pressure: Relief Valve Setting: Operating Temperature: Time in Service: Surrounding Conditions: Past History of Returned Product in This or Similar Applications: psi psi F Flow Rate: System Spikes: Ambient Temperature: Bend Radius: GPM psi F

Other Remarks:

Person Completing Technical Problem Checklist:

PD2448 1/98 (TPC)