Lube check

Sample Collection Form

Please fill in the form as completely as possible and print it out before sending it to us. Submit your printout to the Technical Services department, together with the oil sample. We need a minimum of 100 ml sample in a clean/new plastic bottle (not glass) for a complete analysis. After receiving the oil sample, we will need approximately 10 days to provide you with the results.

Attention: Please fill in one form per oil sample!

Contact details

Company name*

Business location*

Address*

Full name*

Phone number*

Email address*

Lubricant in use

Sample collection date*

Identification number*

Brand*

Product name*

Type*

Lubricant type designation*

Lubricant product data sheet*

Lubricant service life*

Unit*

Topping up (in litres)*

Oil type*

Reason analysis*

Equipment in use

Brand*

Type*

Registration number/Identification number*

Year of construction*

Carter capacity (liters)*

Equipment service life*

Equipment part*

Note!

Some answers have a follow-up question. Please answer one of the questions below if relevant.

» Engine

» Transmission

» Fuels

» Hydraulics

» Cardan drive

» Other

Additional explanation

Don't forget to print out this form before clicking send!

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Location settings

Oil Sample Analysis

Lube check

Sample Collection Form

Contact details

Lubricant in use

Equipment in use