015_Field_Service_Report_(Fillable_PDF_template).pdf
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- W56JSR-17-R-0021
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Field Service Report (Fillable PDF template)
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Template Revision 7 - OCT 2015
C4ISR SERVICE REPORT
IR NO: Date Opened: Category: (Check Applied Systems)
IBS Radar ECDIS MOBI
UPS VHF DSC NAVTEX
Weather
InMarSat Gyro
Software
GMDSS
Contact Person Contact Telephone No.1
Contact Email Contact Telephone No. 2
Vessel Location Vessel No.
Service Date (Start) Service Date (Finish)
FAULT SUMMARY IAVA Version: Tactical Radio Version:
SERVICE DETAILS
Include: <Fault> <Troubleshoot> <Parts> <Cause> <Additional> & <Communications>
PRODUCT DEFICIENCY INFO
Make: Model: Serial No.
Make: Model: Serial No.
Make: Model: Serial No.
REPLACEMENT PARTS
Make: Model: Serial No.
Make: Model: Serial No.
Make: Model: Serial No.
Make: Model: Serial No.
Date CFSR Labor Hours Travel Hours
S/T O/T S/T O/T CFSR (Print Name)
CFSR
(Signature / Date)
POC/GOVT REP (Printed Name)
NOTE: Any parts that have been replaced during service and have not been identified by the Government for refurbishment will remain on the vessel as Government property. Disposition is the responsibility of the owning Unit.
POC/GOVT REP
(Signature / Date)
POC/GOVT REP physically inspected/verified repair?
YES NO
MTS
DGPS
ECS
Other:
VMAIL/SALTSSPP BGAN/GRRIP
AIS
LoudhailerTactical Radio
BFT
IFF
Template Revision 7 - OCT 2015
IR NO:
SERVICE DETAILS CONTINUED
PRODUCT DEFICIENCY INFO
Make: Model: Serial No.
Make: Model: Serial No.
Make: Model: Serial No.
Make: Model: Serial No.
REPLACEMENT PARTS
Make: Model: Serial No.
Make: Model: Serial No.
Make: Model: Serial No.
Make: Model: Serial No.
| C4ISR SERVICE REPORT |
| IRM NO: |
| SERVICE DETAILS |
| PRODUCT DEFICIENCY INFO |
| REPLACEMENT PARTS |
| IRM NO: |
| SERVICE DETAILS CONTINUED |
| PRODUCT DEFICIENCY INFO |
| REPLACEMENT PARTS |
| C4ISR SERVICE REPORT: |
| Contact Person: |
| Contact Telephone No1: |
| Contact Email: |
| Vessel Location: |
| Vessel No: |
| Service DateStart: |
| Service DateFinish: |
| IAVA Version: |
| Tactical Radio Version: |
| Make: |
| Serial No: |
| Make_2: |
| Serial No_2: |
| Make_3: |
| Serial No_3: |
| Make_4: |
| Serial No_4: |
| Make_5: |
| Serial No_5: |
| Make_6: |
| Serial No_6: |
| Make_7: |
| Serial No_7: |
| DateRow1: |
| CFSRRow1: |
| STRow1: |
| OTRow1: |
| STRow1_2: |
| OTRow1_2: |
| DateRow2: |
| CFSRRow2: |
| STRow2: |
| OTRow2: |
| STRow2_2: |
| OTRow2_2: |
| CFSR Print Name: |
| DateRow3: |
| CFSRRow3: |
| STRow3: |
| OTRow3: |
| STRow3_2: |
| OTRow3_2: |
| DateRow4: |
| CFSRRow4: |
| STRow4: |
| OTRow4: |
| STRow4_2: |
| OTRow4_2: |
| CFSR Signature Date: |
| DateRow5: |
| CFSRRow5: |
| STRow5: |
| OTRow5: |
| STRow5_2: |
| OTRow5_2: |
| DateRow6: |
| CFSRRow6: |
| STRow6: |
| OTRow6: |
| STRow6_2: |
| OTRow6_2: |
| Make_8: |
| Serial No_8: |
| Make_9: |
| Serial No_9: |
| Make_10: |
| Model_8: |
| Serial No_10: |
| Make_11: |
| Model_9: |
| Serial No_11: |
| Make_12: |
| Model_10: |
| Serial No_12: |
| Make_13: |
| Model_11: |
| Serial No_13: |
| Make_14: |
| Model_12: |
| Serial No_14: |
| Make_15: |
| Model_13: |
| Serial No_15: |
| IBS: Off |
| Radar: Off |
| ECDIS: Off |
| VHF_DSC: Off |
| DGPS: Off |
| AIS: Off |
| Weather: Off |
| InMarSat: Off |
| ECS_INSA: Off |
| Gyro: Off |
| Tactical_Radio: Off |
| Software: Off |
| SPP: Off |
| Yes: Off |
| No: Off |
| FAULT SUMMARYRow1: |
| SERVICE DETAILSRow 1: |
| MOBI: Off |
| NAVTEX: Off |
| UPS: Off |
| BFT: Off |
| ECS: Off |
| Loudhailer: Off |
| IFF: Off |
| BGAN_GRRIP: Off |
| VMAIL_SALTS: Off |
| Other Row1: |
| OTHER: Off |
| IRM NO: |
| SERVICE DETAILSRow2: |
| Contact Telephone No2: |
| Model: |
| Model_7: |
| Model_2: |
| Model_3: |
| Model_4: |
| Model_5: |
| Model_6: |
| MTS: Off |
File details come from the government source that posted it. Updated .