Sullair Corporation
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Request for On-Site Service
Sullair Corporation Tel: 219-879-5451
Service Department Toll Free:1-888-SULLAIR
1625 E. 2nd St.
Michigan City, IN 46360 Email: service.department@
When requesting on-site services, please fill out this form and e-mail (service.department@) or fax to (219-878-4206) Sullair Service Department.
Customer Information Distributor Information
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Sullair Equipment Information:
|Model Number | | | |
|Serial Number | | | |
|Air End Serial Number | | | |
Personal Protective Equipment Required: (Check all that apply)
Arc Flash Protection*Hardhat Safety Glasses Safety Shoes Face Protection
Goggles Ear Plugs Respirator* Gloves* Clothing*
Air Monitor* Nomex Suit*
* describe in detail below what type
Description of Problem/Services Needed: (attach photos or sketches if available)
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Desired Dates Of Service:
|Start Date: | |
|Start Time: | |
Print Name Date
| |2/1/2011 |
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