TANZANIA BUREAU OF STANDARDS

CONTROLLED
METROLOGY LABORATORY
DOCUMENT NO: TITLE: Customer REVISION: 11 COPY NUMBER:
TBS/DTM/F1MET-QM- calibration ISSUE: 1 Page 1 of 5
401 request form ISSUED TO:
DOC. TYPE: PREPARED BY: APPROVED Effective ISSUE DATE:
PROCEDURE MM BY: DTM Date: 2023-02-20
2023-03-01
Sign: Sign:

CUSTOMER NAME  -
AND  -
ADDRESS  -
CUSTOMER’S LOCATION  -
PARAMETER
IDENTIFICATION POINTS TO BE
S/N EQUIPMENT NAME SERIAL NO. TO BE
No. CALIBRATED
CALIBRATED

Contact person and title:……………………………………………………………………

Phone number:………………………………………………………………………………
Email ………………………………………………………………………………………..
Signature:………………………………………………………………………………….
Date:……………………………………………………..................................................
Note1. The equipment/items listed shall be in good order and working.
2. Extra page may be attached for more information.
3. The form should be dully filled to facilitate the calibration process.