Title Page
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Office Use only QC22-
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Conducted on
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Prepared by
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Company Name or Customer Name
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Contact Phone Number
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Installation Address
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Product Code
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Batch Number
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Product Description
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Number of units installed
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Installation Date
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Number of units Faulty
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Fault Detection Date
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Original Invoice/ Purchase order number
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Date of purchase
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Wholesaler Name
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Has the Wholesaler raised an RFC for these goods?
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Premises desciption
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Description of issue
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Has the light been installed
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Take picture of the light in it's installed location
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Product install location
- Bathroom
- Kitchen
- Bedroom
- Lounge
- Outside
- Other
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Please Specify
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Take picture of the issue with the light fitting
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Daily Operation Hours
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Lighting control system description
- Light switch
- Dimmer
- PIR
- RVAZ-RC
- R5MRGB-WIFI
- RVARGBW-WIFI
- Other
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Please specify
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Ambient Temperature
