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Error Form
Kentucky Oil and Refining Company
156 KY Oil Village
Betsy Layne, KY 41605
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Error Form
Contact First Name:
*
Contact Last Name:
*
Contact Phone Number:
*
Contact Email Address:
*
Type of Ticket Error:
*
INCORRECT BARRELS
INCORRECT METER / GAUGED COMPONENT
INCORRECT PROPERTY
INCORRECT TANK
INCORRECT DATE
INCORRECT PAYMENT
MISSING TICKET FROM RUN STATEMENT
Ticket Number:
*
Ticket Date:
*
Month (MM)
Day (DD)
Year (YYYY)
Operator Name:
*
Operator Number:
*
Lease / Property Name:
*
Lease / Property Number:
*
Tank Number:
Special Instructions / Comments: