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Analytical Request
You will need to have Adobe Acrobat Reader to read the PDF file. Click on the link below to get a free version of Adobe Acrobat Reader. Then use your browser BACK button to return to this page.
Directions for filling out and submitting your sample request:
1. Click on the link to Antifreeze/Coolant, Heat Transfer Fluid or Glycol Only Sample Submission form (pdf) below. This will open the form into Adobe Acrobat.
2. Fill in form by clicking on the top line and type your information. Use TAB or ENTER/RETURN to switch between fields. You can also print the form and fill it out by hand (see step 3b)
3. When all information has been entered you can save it to your hard drive and/or just print it.
a. To SAVE the form to your hard drive, click on the small DISK icon in the Acrobat reader program (not the disk icon on your browser), type in a file name of your choice and chose where you want to save it (My Documents folder, etc.), click SAVE. One you save the PDF file, you can use it to fill out a sample analysis request at any time. You may save each analysis submission using the SAVE AS command so you don't overwrite the original blank form.
b. To PRINT, fill in all your information (or leave blank to fill in by hand) and select the PRINTER icon in the Acrobat reader program (not the printer icon on your browser), print 2 copies (one for your records and one to send to Additives Inc.). You can edit the anything on the page until you close your browser, at which time all changes will be lost. If you want to save your completed form, follow the steps in "a" above to SAVE your completed form.
Approximate turn around time for samples is one week upon their arrival to our Laboratory. Immediate analysis is available on a need basis. Please note in the problem/comments section on the submission form if you need a faster turnaround time.
If you have trouble downloading the form, send an email to customerservice@additivesinc.com and request us to email you a copy. In your request be sure to note which form you need: Antifreeze/Coolant or Heat Transfer Fluid.
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