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Oil Sample

Details

Fill out and submit this form to fulfill requirements of PEM’s Limited Warranty.

Along with submitting this form, please mail the oil sample to the address below.

For additional information, click HERE to download and review the published terms and conditions of the warranty.

Send Oil Sample To:

Power Engineering & Manufacuturing, Ltd.
Attn: Jim Steffy, Customer Service Representative
2635 WCF and N Dr.
Waterloo, IA 50703
USA

Gearbox Information
Gearbox Model #*
Gearbox Serial #*
Company Information
Company Name*
Company Industry*
Contact Name*
Contact Title*
Email*
Phone*
Address
Street Address Address Line 2 City State ZIP Code
Oil Sample Information
Date Oil Sample Taken*
MM slash DD slash YYYY
Sample Taken By (Name)*
Oil Type / Viscosity*
Gearbox Hours of Operation*
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