Casing Order Form

To place a new order, please submit the form below. Please phone us at 661-768-9224 to let us know you have placed an on-line order or if you have any questions.

Today's Date	Due Date	Due Time
Customer Name
Customer Email
Company
Rig #	Well #	AFE/PM#
Contact Name
Contact Phone

Truck Type	Deliver w/ Hydro-Crane Stage w/ Straight Truck	Collar Direction	Front Rear
Wellhead	Yes   No

Order Specifications
Casing/Tubing Size		Weight
Grade		Thread
Footage Requested		Pup Joints, etc.
Special Instructions		Total Footage Requested (incl. pumps and misc. pieces)