Main Content Your Information - Instrument Repair Your Full Name (Last, First) Your UW Email If this is for a course or research project, please provide that name here (example: TBIOMD 499) Faculty Name (leave blank if you are the faculty completing this form) Your Telephone Number What Instrument(s) Is In Need of Repair? Agilent GC Agilent GCMS Agilent ICPMS Beckman Coulter PSA Millrock Benchtop Freeze-Dryer Nanalysis NMR Perkin Elmer UV/Vis Perkin Elmer FTIR Shimadzu AA Shimadzu GC Steris Autoclave - In Science Building Steris Autoclave - In TPS Building Westco Nutrient Analyzer Other… Enter other… Current Location of Equipment (example: SCI 309) Approximate Date & Time Problem First Occured Approximate Date & Time Problem First Occured: Date Approximate Date & Time Problem First Occured: Time What component appears to be directly affected? Please include part number if visible Is there an error or error code? Please enter the error text here What state was the instrument in when you left? (still in error, powered on/off, leaking, etc.) Describe the Problem Please include any other information related to the problem. Any meter readings like pressure, flow rate, temperature, etc. What occured just prior to the problem? Were you performing any actions to the hardware or software when or before the problem occured? What is your sample preparation and has it changed (if so, how?). Please Upoload Any Pictures or Videos You Have Regarding the Problem One file only.15 MB limit.Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. Please Upoload Any Pictures or Videos You Have Regarding the Problem One file only.15 MB limit.Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. Leave this field blank
