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Recycled Fuel Oil – AE Delivery Information Request Form

Please use this form to inquire about Accurate Energy delivering material to your facility. Complete as many of the fields below as you can. None of the fields are required. If there is information that is unavailable or not applicable leave that field blank.

Company
Contact Name
Phone Number
Fax Number
E-mail Address
	A copy of this form will be sent to the above e-mail address.
Location of Delivery:
Street Address
City
State
Zip
Product Type
Volume (Gal/Year)
Average Delivery Amount (Gal)
Comments
Your Required Specifications
API, GRAVITY
SULFUR, WT. %
VISCOSITY
FLASH PT. DEGREES F
POUR POINT, DEGREES F
WATER, VOLUME %
SEDIMENT, WT. %
ASH, WT. %
BTU'S PER GALLON
HALIDES, PPM
ARSENIC, PPM
CADMIUM, PPM
CHROMIUM, PPM
LEAD, PPM
PCB'S, PPM
	Please enter this security code in the box below.
A value is required.