Bulk Fuel Order Form

Delivery
Customer/Company Name*
Island*
Street Address for delivery*
City*
Requested Delivery Date*
Date Format: MM slash DD slash YYYY
Purchase Order # (if applicable)
Contact
Contact Person*
First Last
Contact Phone*
Email*
Order
Products*
Check ALL products you want to order.
- Regular 87
- Non-ethanol 89
- Super 92
- Highway diesel (clear)
- Off road diesel (red)
- Other (please notate below)
Regular 87 Gallons*
Non-ethanol 89 Gallons*
Super 92 Gallons*
Highway diesel (clear)*
Off road diesel (red)*
Special Instructions/Tank ID
Please allow at least 24 to 48 hours notification for fueling request to be delivered. Minimum product bulk delivery order size is 300 gallons above ground tanks, and 800 gallons for underground tanks. Hawaii Petroleum loads are sometimes routed by geographical area. Days of the week for a route may vary and limit availability. Tanks must be properly labeled with product identification and compliance labeling.
Comments
This field is for validation purposes and should be left unchanged.

Delivery