ecoSmart Return Form Return Form

NOTE: Internet Explorer has a built in pop-up blocker that is on and working.
This will prevent printing label and cause blank page issues. PLEASE do the following
Go to Internet Options->Privacy and temporarily disable the blocker or
select settings and add http://www.gascogas.com to allowed sites.

Please enter a First Name
Please enter a Last Name
Please enter an Address
Please enter a City
Please select a State
Please enter a Zip Code
Please enter a Phone Number
Please enter a valid email
Please enter Safety Distributor Name

NOTE: Before returning an ecosmart cylinder, please be sure cylinder pressure is less than 29.0 psig.
Release cylinder pressure using eco M/T plug. (Regulator can also be used)

All hazard markings must be covered or removed indicating the cylinder does not contain a hazardous
material. Peel off label wrap by pulling on perforated strip. (an empty sticker is then shown) Thank you.

Box 1 - Enter Quantity

44L/58L/66L
116L
650L

Box 2 - Enter Quantity

44L/58L/66L
116L
650L

Box 3 - Enter Quantity

44L/58L/66L
116L
650L

Box 4 - Enter Quantity

44L/58L/66L
116L
650L