Contact Information

Your Name*

Company*

Phone*

Email*

Address

City

State

Zip

Product Information:

Product

Bulk Density

Particle Shape

Temperature

GRANULARPOWDERABRASIVEELECTROSTATICDUSTYSTICKYCORROSIVEFREE FLOWINGAGGLOMERATES EASILY

Application Information

Screener Rerquirement

SIZESCALPDE-DUSTDE-WATEROTHER

Process Type

DRYCONTINUOUSWETBATCH


Feed Rate

Lbs/Hr

Kgs/Hr

Gal/Hr

Tons/Hr

Process Type

PROCESS BEFORE SEPARATOR:

PROCESS AFTER SEPARATOR:

EXISTING EQUIPMENT:

MATERIAL of CONSTRUCTION:

Additional Comments:

SKIP THIS SECTION IF YOU ARE USING THIS FORM TO REQUEST A QUOTE.


Testing Information

If you are submitting materials for testing, please complete the following section and submit this form before shipping the test material to our lab. Discuss the amount of test material required prior to shipment.

We do not accept material freight collect.

Shipping information

Material Safety Data Sheet attached?
YesNo

Number?

Quantity Shipped:

Date of Shipment:

Carrier Service:

Return Shipment Instructions

Return all materialReturn samples & removed dust onlyNo returns necessary

Carrier:

Account number for return:

Test Objectives

SCREEN #1:

SCREEN #2:

SCREEN #3:

SCREEN #4:

Purpose of Testing: