Fuel Treatment Diagnostic Form

Please complete one form per boiler or system. Click on Submit when ready to send.

Warning: Since this form is large, it takes a while to transmit, once you press SUBMIT, so please be patient. An acknowledgement page WILL show up.

For this form to work, check that the URL address reads

"http://www.alken-murray.com/form-fueladditiveauto.html"

Company Name:

Client or Distributor's E-mail address:

Address:

Telephone Number:

Contact: (Name & title)

AM Distributor

Send instructions/reports to:

Industry Type:

Products manufactured

Fuel Flow in Gallons per Day

**Sludge Accumulation**

(measure with Bacon Bomb Sampler, if possible)
8 inches above the bottom
12 inches above the bottom
36 inches above the bottom
48 inches above the bottom
Does the storage tank have a drain?	Yes No
Size of storage tank (gal or m3)

**Fuel Oil Average Analysis**
(your fuel supplier should answer these questions)
PARAMETERS	TEST METHOD	SPECS LIMIT	FINDINGS
Gravity, API@ 60 deg. F
Density @ 15 deg. C
Kinematic Viscosity @ 50 deg. C
Flash Point, deg C
Pour Point, deg C
ASH, % wt
Sulfur, % wt
Sediment by Extraction, % wt
Bottom Sediment & water, % vol
Carbon Residue, % wt
Free Water, % vol
Vanadium, ppm
Sodium, ppm
Other

**Three-month Load Averages**
	High Load	Low Load
Pounds per Hour
Hours per Day
Air or O2
Carbon Dioxide or CO2
Air Temperature at Preheater Inlet
Air Temperature at Preheater Outlet
Flue Gas Temperature at Preheater Outlet
Stack Temperature
Superheater Temperature
Blowdown Volume

**Deposits Analysis**
Combustible Carbon , as C %
Water Soluble Fraction, as such, % (Approx.)
pH of 1% solution
Sulfates, as Na2SO4, %, (Approx.)
Nickel, as NiO, % (Approx.)
Vanadium, as V2O5, % (Approx.)
Iron, as Fe2O3, % (Approx.)

Acid Soluble Fraction, as such % (Approx.)
Calcium, as CaO, % (Approx.)
Magnesium, as MgO, % (Approx.)
Nickel, as NiO, % (Approx.)
Vanadium, as V2O5, % (Approx.)
Iron, as Fe2O3, % (Approx.)
Other Acid Soluble Fraction

Insoluble Fraction, as such % (Approx.)
Silica, as SiO2, % (Approx.)
Aluminum, as Al2O2 (Approx.)
Nickel, as NiO, % (Approx.)
Vanadium, as V2O5, % (Approx.)
Iron, as Fe2O3, % (Approx.)
Other Insoluble Fraction

Additional Information

We usually add all people who inquire about our products to our newsletter mailing list, which is kept for in-house use. We do not ever sell or trade names of our clients, and rarely contact by e-mail more than once a month.

Mailing list: YES NO

for original format to print, fill-in with a pen and fax