Serving South Metro Atlanta and North Central Georgia since 1948

Refill Order Form

Please fill in the requested information below to request a gas refill.

Senior Citizen Discount ( 60+ yrs. old ) is $.03 per gallon
Automatic Keep Full Discount is $.02 per gallon
Direct Payment Customers Discount is $.02 per gallon

Please note: Pricing is subject to change.  Please contact us with any questions.
This delivery will be made the next business day after you submit this form!
Please do not enter any credit card data in the “Comments” section.
Due to changing prices you should call for current pricing. 

Griffin 770/228-8484

McDonough 770/957-2501

Customer Name

Customer Email

Daytime Phone Number

Street Address

City

Account Number (if known)

Quantity Requested for Delivery

Payment Method

Your Comments

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