Wholesale Account Info Sheet


Company Name(print)_____________________________________Authorization Signature ______________________________________Date___________________

Return Street Address_________________________________________________________

(no PO boxes please) Is this a residence? _YES OR NO_ (circle one)xxxxxxxx UPS Number___________________

E-mail _________________________ Phone_________________________Federal Tax Id#______________________(0) check if on file

Please Identify each bottle type (E#, 3al or 3HT)

Bottle 1____________________Bottle 2____________________Bottle 3____________________Bottle 4__________________Bottle 5___________________

Bottle 6____________________Bottle 7________________________Bottle 8____________________Bottle 9__________________Bottle 10__________________ ..

Special Instructions to Hydrolab

Instruct HydroLab to do the following, (check all that apply, each price is per bottle)

__ Hydrotest Cylinder _____X x $16.00 =
__ Remove Valve (must be removed for testing) _____X x $2.50 =
__ Re-attach Valve _____X x $2.50 =

__ Regulator Rebuild (can be done without hydro service)
PMI Old and New Basic service (top not replaced)

_____X x $12.50 =
__ Pre Paid Shipping ($10 per bottle) _____X   =
    total =
*Washington state residents, please enclose 8.5 % tax.

Enclose Personal Check, Money Order, cash or with the following credit card information.

Credit Card#________________________exp__________

Name on card__________________________
(VISA, MasterCard, Amex) circle one)

Signature of card holder_________________________
(needs to match name on card.)
*Credit card payments must include: Number, expiration date and signature.
**You will be billed regardless of pass/fail of bottle.

Ship to:
5000 Burwell st
Bremerton, Wa. 98312

1. Remove all air from bottle
2. Make sure your company name is on the bottle (use tape, write your full name)
3. Remove any covers or protectors and valve (or indicate that you want us to remove it).
4. You will need to put your valve back onto the tank, and make the appropriate adjustments after we return your tank. Check all attachments for seal and security upon return of bottle.
5. Bottles received on Friday, may be shipped on Monday. Most will be shipped on the day recieved.
6. We recommend that you seek out the advice and services of a quality airsmith for removal and replacement of your Valve/regulator, or request HydroLab to re-attach the valve.

Check all attachments for seal and security upon return of bottle.
  • We provide valve removal and replacement as a optional service. This service is not a requirement, for us to Hydrotest the bottle. However, all valves must be removed to be tested.
  • Bottles that are tested and NOT recertified (did not pass Hydrotesting), will be rendered inoperable (hole drilled in them).
  • Full payment of the Hydrotest fee is required, regardless of certification status.
  • Questions.... no problem... use the HydroLab HotLine: 877-HYDROLAB between 10 am and 6 PM Pacific Time. Or email info@hydrotester.com