Your Company Information

Company Name__________________________________

Contact Name__________________________________

Address__________________________________

Telephone Number__________________________________

Email__________________________________

Compressor Data

Compressor Mfg.__________________________________

# of Compressors Installed__________________________________

Type & Model __________________________________

Total Compressor Capacity__________________________________

Compressor Lubricant Data

Lubricant Mfg.__________________________________

Lubricant Name__________________________________

Optional Additives/Impurities__________________________________

Factory Data

What does the factory make?__________________________________

Air intake drawn from inside/outside__________________________________

Application Data

Standard Working Pressure (PSI)__________________________________

Operating Hours/Week__________________________________

Compressor Hours/Week__________________________________

Oil Consumption/Month__________________________________

Condensate Generated/Hour__________________________________

Compressed Air Temp __________________________________

Compressed Air Temp After Dryer__________________________________

Environmental Data

Ambient Temperature Degree F__________________________________

Relative Humidity__________________________________

Oil/Water Separator Data

Manufacturer/Model__________________________________

Date of Installation__________________________________

Date of Last Element Change__________________________________

Oil Residue From Outlet (PPM)__________________________________

*Please include any MSDS files on compressor lubricate.

*If any determination was made by a laboratory test, please include a copy of the test report.

 

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