SAMPLE NO.
LAB REPORT NO.
PETROLEUM PRODUCTS LABORATORY ANALYSIS REPORT
For use of this form, see FM 10-67-2; The proponent agency is TRADOC
PRODUCT NOMENCLATURE AND TYPE
SPEC. NO.
SAMPLE SUBMITTED BY (Installation)
AMT PROD SAMPLE REPRESENTS
MANUFACTURER OR SUPPLIER OF PRODUCT
SOURCE OF SAMPLE (Truck, Tank, Aircraft, etc.)
FSN
DATE SAMPLE TAKEN
SAMPLE TAKEN BY (Name)
CONTRACT NO.
ITEM NO.
DLVR DATE
DATE SAMPLE REC
QUAL NO.
BATCH NO.
FILL DATE
DATE TESTS STARTED
NAME AND LOCATION OF LABORATORY
FUEL BULK STORAGE
ROUTINE SURVEILLANCE
FUEL PACKAGED
PROCUREMENT ORIGIN
DATE TESTS COMPL
ALLIED PRODUCTS
PROCUREMENT
FILTER EFFECTIVENESS
SPECIAL
QUALIFICATION CONTRACT
DEPOT
TEST
SPEC/
RESULT
TEST
SPEC/
RESULT
QUAL
QUAL
27. WATER AND SEDIMENT % VOL
MAX
1. GRAVITY API/SP GR 60/60F
TOP
28. FSII % VOL
TOP
a.
MID
b.
BOT
a.
MID
c.
AVG
b.
BOT
2. APPEARANCE/WORKMANSHIP
c.
AVG
3. COLOR
VISUAL
29. PARTICULATE CONTAMINANT MGS/GAL
30. THERMAL STABILITY INCHES HG
a. HELLIGE (Colorimeter)
b. ASTM MAX/SAYB MIN
a.
PREHEATER RATING
c. SAYB AFTER HEAT MIN
31. SULFIDES (Tank Water BTMS)
4. ODOR
32. WATER SEPAROMETER INDEX MIN
5. DISTILLATION
1BP
...F
33. % ASH PLAIN/SULF MAX
34. % LEAD
a.
10
% REC -
EVAP AT
...F
35. % PHOSPHORUS
b.
50
% REC -
EVAP AT
...F
36. % CHLORINE
c.
90
% REC -
EVAP AT
...F
d.
% REC -
EVAP AT
...F
37. BURNING TEST (16 hrs)
38. KIN CS/SSU AT
...F
e.
FBP/DRY PT
...F
f.
% RECOVERED
a. KIN CS/SSU AT
...F
g.
% LOSS
b. KIN CS/SSU AT
...F
h.
% RESIDUE Max
c. KIN CS/SSU AT
...F
i. 10% + 50% EVAP
...F MIN
d.
SSF AT
...F
6. ENGINE RATING O.N. MOTOR METHOD
e. VISCOSITY INDEX MIN at 40 degrees C
39. EVAP LOSS % MAX
a. ON RESEARCH METHOD
40. PRECIPITATION NO MAX
b. LMR AVIATION METHOD
41. SEPARATION % MAX
c. RMR SUPER CH METHOD
42. ACID NO/BASE NO MAX
d. CETANE NUMBER/INDEX MIN
43. CHANNEL PT
...F MAX
7. RVP (PSI)
8. GUM EXISTENT MG/100 ML MAX
44. SAPONIFICATION NO MAX
45. DIELECTRIC STRENGTH KV MIN
GUM (Wash)
MG/100 ML MAX
GUM POTENTIAL MG/100 ML MAX
46. FOAM SEQ 1. MLS MAX (TND/STAB)
PRECIPITATE MG/100 ML MAX
a. SEQ 2. MLS MAX (TND/STAB)
9. TEL/TML (ML/GM/GAL) MAX
b. SEQ 3. MLS MAX (TND/STAB)
10. OXIDATION STABILITY MINUTESMin
47. PENETRATION UNWORKED
77...F
11. DR TEST/MERC S% MAX
a. PENETRATION WORKED
77...F
12. SULFUR BY LAMP BOMB % MAX
48. DROP PT/MELT PT
...F MIN
13. FREEZING PT
...F
49. CORR AND OXIDATION STAB
14. CORROSION COPPER STRIP 3 hr @ 122 degreesF
50. SWELLING SYN RUBBER %
15. AROMATICS % VOL MAX
51. LOW TEMP STABILITY
16. OLEFINS % VOL MAX
52. SALT SPRAY TEST
17. SMOKE POINT MM MIN
53. WORK STABILITY
18. SMOKE VOLAT INDEX MIN
54. WATER STABILITY
19. ANILINE PT
...F/ANILINE GRAV PROD MIN
55. THICKENER TYPE
20. FLASH/FIRE POINT
...F MIN
56. THICKENER CONTENT %
21. CLOUD POINT
...F MAX
57. CORROSION PROTECTION
22. POUR POINT
...F MAX
58. REMOVAL
23. WATER REACT INTERFACE RATING MAX
59. APPARENT VISC AT
...F
a.
VOLUME CHANGE MAX
a. SHEAR RATE POISES
24. CARBON RESIDUE % WT MAX
60. SED CONTAM. MILLIPOE, MG/L, MAX
25. WATER % VOL MAX
61. EFFECTIVENESS OF FILTRATION min
25. SEDIMENT % VOL MAX
62. OTHER (Specify)
Sediment Volume
REMARKS
DATE FORWARDED
SIGNATURE
TITLE
DA FORM 2077
EDITION OF 1 MAR 62, IS OBSOLETE
U.S. GPO: 1989-0-230-313
10-5
QM 5092
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