Coolant Test Form
Company
*
Date
First Name
*
Last Name
*
Email
*
Address
*
Phone
*
City
*
State
*
AK
AL
AR
AZ
CA
CO
CT
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Other
Zip Code
*
Country
*
United States
Canada
Mexico
Israel
Other
Objective
Present Method of Separation
Media
Project Objective
*
Coolant
Brand of Coolant
Type of Coolant
Synthetic
Oil
Water Soluble
Operating Temperature
Density/SG
pH
Viscosity
Tramp Oil Significance
Process Information
Flowrate in GPM
Expected solids loading in feed would be (pounds/8 hour shift)
Workpiece Material
Operation
Finished Product
Clean return pressure
Is filter aid allowed
Yes
No
Preference
Maximum Allowable Filtrate Solids in PPM
Any Known Hazards
Comments
Completed by:
Customer Rep
Oberlin Rep