Lab and Analysis Inquiry Form
Personal Information
First Name:
Last Name:
Email Address:
Street Address:
Zip/Postal Code:
City:
State:
Phone Number:
Fax Number:
Country:
General Comments:
Technical information
What is the Problem?
what Lubricant was successfuly used in the past?
What is the usual application method?
If Omega products was used, how was it applied?
How frequently was the parts lubricated?
Why did the lubricated not perform?
What operating temperature was lubricant subjected to?
What was the surrounding the temperature?
What the lubricant subjected to
(i) Moisture?
What type of contamination was present? (e.g.grit, dust, acid, solvent, etc)
Other information required?
How quickly is information required?
