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PNEUMATIC CONVEYING APPLICATION FORM

Company:

Attention:

Address:

Phone:

Fax:

[1] What is the Product? Common Name Trade Name:

[2] Bulk Density of the Product in g/cc

[3] What is the Major Characteristics of the Material? [Please Check all that apply

Pellet	Granule	Dusty	Abrasive
Powder	Flake	Acidic	Cohesive
Radioactive	String	Fiber	Caustic
Fragile	Corrosive
Toxic: YES NO
Explosive: YES NO	If 'YES' describe	possible information:

[4] What is the Particle Size Range of the Product?

Microns:		[or] Mesh
[or] Inches		[or] Specify

[5] What are you conveying distances?
Vertical: Horizontal:

[6] Are you concerned about? Segregation Breakage

[7] From How Many Pick Up Points will the material be conveyed?

Material to be conveyed from:
Fiber, Plastic of Metal Drum
Bulk Bags or Super Sacks
Paper or Plastic Bags
Large Box
Storage Hopper or Silo

[8] How Many discharge points will the material be delivered to?

Mixer		Blender
Reactor		Filling Machine
Silo		Tank
Mill		Screen
Dryer		Tablet Press
Volumetric Feeder		Loss-In-Wt. Feeder
Other		Other

[9] How much headroom do you have over the equipment to be fed?

[10] Will our equipment be subjected to fumes, heat or vapor emitted from the equipment being fed?

[11] What type of enclosure is required for control panel and junction boxes?

General Purpose Dust-Proof	Water-Tight; Carbon Steel Painted
Water Tight Stainless Steel	Explosion Proof [Specify]

[12] Do you require a specific construction matrial for system components in contact with the product?
Please Mention the MOC required for contact parts:

SS 304	SS 316
SS 316L	Others

[13] Have you handled this product pneumatically?

What problems, if any?

Did one particular filter medium work better than the other?

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Thank you for answering the above questions. We will be able to offer you a more precise
quotation based on the above answers.

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