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Customer Request

Customer Information

Date :15 /12 /2024

Company Name :

Address :

Contact person :

Fax :

Tel :

Mobile :

E-mail :

Please Fill 1 or 2

1 Request same chamber

(Refer name plate)

Model :

S/N :

Remark :

2 Request New chamber

Oven Tempurature chamber
Tempurature and humidity chamber Thermal shock

Temp / Humid and test condition

Temp / Humid

Tempurature range

～

°C

Humidity range

～

%RH

Test condition

Tempurature range

～

°C

Humidity range

～

%RH

Size and detail of specimen

Size of chamber (request)

* D

* H

Material

Detail of specimen

* D

* H

Weight

Kg/Pc

Quantity

Estimated PO and Install time

Estimated issue PO date

Month

Year

Installation request

Month

Year

Request option

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Requirement form