Rebuild/Repair Request
Customer Information
Company:
Name:
Title:
Our founder, began 30 years ago by buying old garbage trucks
and completely rebuilding them
Street Address:
City:
State:
Zip Code:
Phone Number:
Email Address:
Fax #
ROBERTS HYDRAULICS
A Division of J L Roberts Industries, Inc.
(817) 831-0676 (800) 831-0674 Fax: (817) 831-0677 (800) 831-0675
Country:
Please Contact Us by:
Zip Code:
Country:
Zip Code:
Street Address:
City:
State:
Street Address:
Billing Address
Shipping Address
Phone Number:
Fax #
City:
State:
Country:
Zip Code:
Phone Number:
Country:
Fax #
Parts Number by Manufacturer
Parts Manufacturer:
Parts Number:
Description of Part
and Repair Required:
Parts Number by Equipment Make/Model
Equipment Mnfr:
Equipment Model #:
Parts Number:
Description of Part
and Repair Required:
Cylinder Specifications -
To clear and start over -
SUBMIT VIA EMAIL when you are ready -
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Serial Number:
Bore Size:
Cylinder Type:
Number of stages:
Stroke:
Operating Pressure:
Rod Size:
Rod Thread Diameter:
Pitch:
Seals:
Type of Mount:
Cushions:
Ports:
Describe
Describe
Describe
Rod:
Describe
Accessories:
Describe
Quantity:
Serial Number:
Serial Number:
Serial or Parts #
