Safety Inspection form

Download the safety bulletin

Repair kit installation instructions for safety switches and enclosed control

2nd notice release May 2019

Eaton manufactured 30A and 60A heavy duty safety switch which may contain a component non-conformance.

Please complete the form below to provide the results of your on-site inspection and request your replacement component. Download safety bulletin for more information. Our team of experts will be in touch with you after required information is received.

First Name *

Last Name *

Email Address *

Company *

Business Phone *

Please verify the location of the equipment

Company name and building owner

Shipping address for sending repair kits

Address 1

Address 2

City *

State or Province *

Zip or Postal Code *

Country *

Purchasing information (if available)

Purchasing order form (Enter your PO number)

Purchased from (Enter the name of your distributor)

Heavy Duty Safety Switches

Results of inspection

Catalog Number * Please list all catalog numbers, each separated by a comma

Qty Identified within Date Range (11/19/15 – 1/23/18) * Please list quantity of each catalog number listed above, with each separated by a comma. Please be sure quantities are in the same order as the catalog numbers above.

Optional: Date Code on Switch (Please list date codes for each unit) Please keep the same order as the catalog numbers. Example: If there are 5 of the first catalog number, list those 5 date codes, comma-separated, then the quantity for the next set of date codes, etc.

Enclosed Control

Results of inspection

Catalog Number Please list all catalog numbers, each separated by a comma

Qty Identified within Date Range (11/19/15 – 1/23/18) Please list quantity of each catalog number listed above, with each separated by a comma. Please be sure quantities are in the same order as the catalog numbers above.