| E-Mail
Address |
|
| Name
of Co. |
|
| Your
Name |
|
| Street
Address |
|
| City,
State, Zip |
|
| Phone
No: |
|
| Type
of Business |
|
| Years
in Business |
|
| Number
of Electric Vehicles/Batteries |
|
| Voltage
for each vehicle/ battery
to be treated |
|
| Amp.
Hour (AH) |
|
| Battery
Manufacturer
|
|
| Batt.
Number and Voltage
|
|
| Date
on Battery
|
|
| Date
Purchased
|
|
Voltage
of each cell
(Forklift Battery)
|
|
Density
of each cell
(Forklift Battery)
|
|
Actual
Voltage
of each cell (Golf cart Battery)
6, 8 or 12 Volt
|
|
Density
of each cell
(Golf cart Battery)
6, 8 or 12 Volt
|
|
Actual
Voltage
(12 volt Battery)
|
|
