Contact Information

Your Name*

Company*

Phone*

Email*

Address

City

State

Zip

Slurry Information

Material Characteristics

VISCOUSSTICKYTHIXOTROPICOILY / GREASY

Other

Maximum Temperature

Specific Gravity

Slurry Contains

FATSOILS

Other

Liquid Medium:

WATERCORROSIVEHAZARDOUS / FLAMMABLEOTHER

PERCENT SOLIDS IN SLURRY:

Minimum

Normal

Maximum


Target Feed Rate

Gallons/Min

Gallons/Hr

FILTRATION TARGET

Mesh

Micron

Inch

SPECIAL MATERIAL NOTES / HANDLING REQUIREMENTS::

CURRENT FILTRATION EQUIPMENT:

OTHER / PROCESS INFORMATION:

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: