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Application Questionnaire



Company Name:
Requesting Party/Telephone #
Address:
City:
State:
Zip:
Country:
e-Mail:

General Specifications

Description of Application:

Chemical Service (include MSDS):
Chemical Manufacturer:
Specific Gravity:
Viscosity:
% Solids and Type:
Thermal Profiles of Material:

Electrical:

NEMA Rating Required:
Available AC Service:
Phase:

Mechanical:
Number of Heads Required:
Material Handling Required:
Vacuum Required:
Heating Required:
Ovens Required:
Projected Flow Rate:
Projected Total Volume/Cycle:
Batch Cycle Time:
No. Parts/Hr:
Part Dimension:

System Control Method:
Open Loop Control:
Closed Loop Control:
PLC Required:
Operator Interface Required:

Other Related Information/Optional Equipment Requested:
Current Project:
Future Project:
Project Scheduled For:
 
Any other pertinent information:




3001 Tamarack Road  Owensboro, KY  42301  Tel: 270-689-1818  Fax: 270-683-4013