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Cooling System Electrolysis-Corrosion
Checklist
Home |
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To determine how
INTER-JECT can help you...
Please print this form and fax it to BMR Fax
(662) 920-8491 |
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Please Record as Much or as Little Detail You feel
is adequate. |
| Firm: ______________________________________ |
| Contact:______________________ Phone:
_________ |
| Address:_____________________________________ |
| City ________________State
_______ZIP___________ |
| (1) Type of coolant water: (Municipal)
(Well) (Distilled) NOTES______________________________________ |
| (2) Type of Shop: (Radiator) (A/C)
(General) (Auto) (Truck) NOTES______________________________________ |
| (3) Location of Your Shop _______________________________________________________________________ |
| (4) I see Rapid Radiator or Heater Cores
about ________times per _____ NOTES___________________ |
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| Make_________ Model_________ Engine________ Year___________
Mileage_______________ |
| Weeks / Months since first repair_______________ Second
_______________ Third_____________ Forth__________ |
| Reason for return: (Heater) (Radiator) (Tube) (Tank)
___________________________________________________ |
| Coolant: (Replaced) (Added // Topped Off) (Reused)
(Unknown) NOTES____________________________________ |
|
Type Coolant & pH: (Unknown)
(Conventional / Silicate) (OAT-DEX-COOL) (G-05) (Hybrid);
pH_______
From: (Refractometer)
(pH / Coolant Test Strip) |
| If Added or Replaced: (New) (Recycled-Purchased)
(Recycled On Site) (Customer Supplied) |
| System Flushed?: (Yes) ( No) (Coolant Replacement
Machine)
NOTES_____________________________ |
| Voltage Check DVOM Volts: (Ground - to - Battery)
(Ground to Block) NOTES_____________________________ |
Was that voltage caused by any of these OE or
aftermarket components being turned on: (Horn) (Radio) (CD-DVD Player)
(Head Lights)
(Parking Lights) (Tail Lights) (Brake Lights) (Panel or Comfort Lights) (A/C
Clutch) (Heater Blower) (Power Seats // Windows // Door Locks)
(Rear Window Defroster) (Blinkers) (Emergency Flashers) (Sun Roof) (Cruise
Control) (Winch) (Cell Phone Charger) (2-Way Radio)
If anything else caused the spike Please list:
__________________________________________________________ |
| Vehicle extra information: (Has It Been In An
Accident?) (Original Battery Cables?) |
| Is it a: (Service Truck) (Ambulance) (Police Car)
(Taxi) (Fleet Vehicle) |
