Sample Submission Form

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Sample Submission Online


116 Sunset Inn Road, Lafayette NJ 07848

Phone (973) 579-3448   E-mail   Fax (973) 579-9447

Sample Submission Form

This form MUST accompany all samples.

In order to avoid delays, please complete ALL sections of this form.

Please enter the date in format mm/dd/yyyy
Company Name/Division as you want it to appear
Company shipping/mailing address
Name of contact person
Phone number with area code
Please list the samples and their identification marks
Please list: Test Method, Time/Temperature, Material Specification, etc.

Rush Testing

ALL RUSH TESTING MUST BE PRE-APPROVED* and will incur at least a 50% surcharge. CALL 973-579-3448 X2 FOR PRE-APPROVAL

Enter the name of the person you spoke to.

Note: We do our utmost to meet rush requests but owing to unforeseen circumstances we do not guarantee results by a particular date in every instance.

* Scheduling of Rush testing will be delayed or may not be available in the absence of pre-approval.

Method of Payment: This section MUST be completed.

Purchase Order, Credit Card, Check or Wire Transfer
Net 30 Days
Credit card information is securely transmitted to Petrolube by email using SSL with 256-bit encryption. For maximum security you may also call in with your credit card number at 973-579-3448 X2

Wire Transfer: If you choose to make a wire transfer you will be contacted with our bank information after your samples have arrived. You will be responsible for all bank fees.

Petro-Lubricant Testing Laboratories, Inc.
116 Sunset Inn Road, P..O. Box 300Lafayette, NJ 07848, USA
Phone: +1 973-579-3448