Lube check

Sample Collection Form

Please complete the form as thoroughly as possible and print it before sending it to us. Send the printed copy to the Technical Services department, along with the oil sample. We need a sample of at least 100 ml in a clean/new plastic bottle (not glass) for a complete analysis. After receiving the oil sample, it will take approximately 10 days to provide you with the results.

Attention: Please fill out a form for each 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!

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Oil Sample Analysis

Lube check

Sample Collection Form

Contact details

Lubricant in use

Equipment in use