First Name *

Last Name *

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Phone Number

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City

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Part #

Part Type *

Vehicle Make/Model/Year *

Tire Size (ex: 225/65R17) *

Number of Tires Attempting to Fill

Starting Tire Pressure (PSI) *

Desired Ending Pressure (PSI)

How Long Was the Unit Running? *

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Size of Puncture (if Emergency Repair)

Tire Size *

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What is the rubber cement in a Slime Tire Plug Kits used for?