SERVICE REQUEST

Fax 515-265-8794 800-362-2910 515-262-5900

SERVICE REQUEST

click here if you want the print and fax option

Company Name
Your Name
Customer #
City
Address
State
Phone #

(Required Information in Red)

IMPORTANT: Please note that your requested service appointment is not guaranteed until you receive a final confirmation. We will contact you as soon as possible to verify your requested service date and time

Vehicle #1 information	Vehicle #2 information	Vehicle #3 information
Unit #	Unit #	Unit #
License #	License #	License #
Year & Make	Year & Make	Year & Make
Model	Model	Model
VIN	VIN	VIN
Description of work Desired Date	Description of work Desired Date	Description of work Desired Date

Please enter the Security ID to the right in the box below -

To Submit form---click below

Federal DOT Cargo Tank Inspection Requirements

Symbol	Inspection	Test Interval (years)
V	External Visual Inspection	1
K	Leakage Test	1
I	Internal Visual Inspection	5
P	Pressure Test	5
T	Thickness Test	as needed

NOTE: If you have more than 3 vehicles to schedule, submit a 2nd form

Seneca Tank 5585 NE 16th Street Des Moines, Iowa 50313

Please e- mail Seneca Tank webmaster with any questions or comments about this web site.