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Please fill out the following form. Let us help you get to the bottom of your filter-plugging problems.

Plugged Fuel Filter Issue Form
Date (xx/xx/xxxx):   Company with the Complaint:
 
Company Location:
 
Type of Fuel Used in Filter:  

Blend %
 
 		 Fuel Supplier:
 

Terminal Name:
 
Where is fuel stored (check one) Above Ground
Underground
Unit Fills
Other, Please Explain

 
Type of Filter (check one) Primary
Secondary
Fuel-Water Separator
Other, Please Explain
 

 
Fuel Additive Yes No

Treat name

Treat rate

Filter Model Type/Number:   Size of filter pore in microns:
Filter in service for: Miles:          
or
Hours:      

 


 
Fuel sample (if some is being sent with filter) was drawn from: Storage tank         Vehicle Tank  
 

Filter                       Other:
 
Short Description of Issue:
      
Temperatures in Fahrenheit: Engine:   Ambient:

 Fuel:

     
Engine Type/Model:    
       

Please print and send this completed form with each filter mailed in for analysis to 2719 Stillwater Road, Maplewood, MN 55119.  Also, please submit the completed form to fuelfilters@yocumoil.com.  Only filters with accompanying completed forms will be analyzed. 

 
 
© 2007 Yocum Oil Company, Inc.