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SERVICE REQUEST / PARTS ORDER
To schedule a service repair or parts request please fill out the form below and one of service team members will be in touch. If this is a emergency please contact us at 800-992-3430 and ask for Customer Care.
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Business / Organization
*
Customer Status
*
Current PJP Customer.
Current General Chemical Customer.
Current ATRA Customer.
Not a Customer.
If you are a current customer, what is your Sales Person's name?
Customer Account Number (If Known)
Primary Site Contact Name
*
First
Last
Primary Site Contact Email
*
Primary Site Contact Phone
*
Secondary Site Contact Name
First
Last
Secondary Site Contact Email
Secondary Site Contact Phone
Service Business Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
What is the current status of the unit? Select all that apply.
*
Operational
Under Warranty
Out of Service
I do not need service.,
Equipment Make
*
Equipment Model
*
Equipment Serial Number
*
Description of Problem/ Parts Needed:
Please describe what is going on with you piece of equipment/ or what parts you need to order, this way when the service tech calls he/she will have all the information they will need to provide a resolution.
Customer Purchase Order Number
*
Additional Comments:
Submit Service Request