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Rising Oil Costs and Environmental Concerns 
Resource Responsibility

How to Fill Out Wearcheck Oil Sample Forms

The sample information form allows the laboratory to match the current sample with historical data from that piece of equipment. The form also contains information such as miles on oil, which aids the laboratory in providing the oil analysis user with proper evaluation of test data*. Complete the form as follows:
  1. Customer Code – If unknown, leave blank. This number may be preprinted by the laboratory.
  2. Unit ID Number – This is the piece of equipment’s identifying number, this must be filled in.
  3. Unit Make – Manufacturer of Unit.
  4. Unit Model – Model number of Unit.
  5. Serial No. – Component Serial number.
  6. Component Make – Manufacturer of component
  7. Component Model – Model number of component.
  8. Component Sampled – Circle the location from where the sample was drawn, i.e. hydraulic, engine, gearbox. If not listed, please circle other and write in the component.
  9. Location – If applicable, circle the location of the component.
  10. Filter Type – Circle type of filter.
  11. Filter Micron Rating – Smallest micron rating of filter
  12. System Oil Capacity – Amount of reservior, qts or gallons
  13. Brand & Type of Oil – Manufacturer of oil and SAE grade
  14. Additive Used – Circle yes or no.
  15. Fuel Used – Circle one
  16. Coolant Type – Circle one
  17. Comments – Indicate any recent maintenance or operating problems.
  18. Sample Date – The sampling date/ Oil Added – How much oil has been added.
  19. Time Units – Indicate time on the oil in miles or hours.
  20. Total Time on Unit – Indicate time on the unit.
  21. Time on Oil – Indicate time on oil
  22. Time on Filter – Indicate time on filter
  23. Changed Oil – Circle yes or no.
  24. Serviced – Circle yes or no for filter service.

This top section above the dashed line should be kept for your records so you have a means to follow up if necessary.

The WCM _________ code designates that the results will show up on the Kleenoil account on their website.


The section below the dashed line needs to be filled in COMPLETELY with the customers company information:

Serial No. = Not necessary
Component Make = i.e. PowerStroke
Component Model = 7.3L Diesel

Unit ID = i.e. Toms Truck
Unit Make = i.e. Ford
Unit Model = F-250

System Oil Capacity = i.e. 8 quarts
Brand & Type of Oil = i.e. Valvoline 10W30
Additive Type = i.e. Power Up

Filter Type = i.e. most of the time would be Element
Filter Micron Rating = Usually just put 25-40 micron full flow and 1 micron Kleenoil Filter

This very bottom section is the MOST IMPORTANT one of all. ALL FIELDS NEED TO BE FILLED IN COMPLETELY!

Sample Date = i.e. 1/25/2005
Time Units = i.e. how the company measures usage on the vehicle / component either in miles, hours, etc.
Total Time on Unit = i.e. since the unit was put into service by the company. Might be 235,000 miles, etc.
Time on Oil = the amount of miles/hours on the oil since the last oil change.
Time on Filter = the amount of miles/hours on the Kleenoil Filter Unit.