Company:* :
ATTN :
Address:
Phone:
 Briefly describe what you want to accomplish:
 
Please answer as many of the following questions as possible
1. What is the product?
Common Name:* Trade Name:
 
2. Bulk density of product
: 0.2 – 0.4 gm/cc : 0.4 – 0.6 gm/cc : 0.6 – 0.8 gm/cc : > 0.8 gm/cc
3. What are the major characteristics of the material? (Check all that apply)
3 a.   : Pellet   : Granule   : Powder   : Flake
3b. What is the particle size range of product?
 Microns :   (or) Mesh Size :   (or) Inches :   (or) Specify : 
3 c.   : Dusty   : Non Dusty   : Abrasive   : Hygroscopic   : Fragile   : Other
3 d.   : Cohesive   : Adhesive   : Acidic
 
4. What are the flow properties of the material?
  : Free Flowing   : Sluggish (will flow with vibration)   : Not free flowing   : fluidizes
  : Does not fluidize   : Fluidizes and Floods   : Compressed (packs)    Angle of Repose :  
 
5. Are you concerned about?
  : Segregation   : Breakage
 
6. What are your conveying distances?
(Vertical)       : 10 – 20 Feet : 20 – 30 Feet : 30 – 50 Feet : 50 – 70 Feet   : >70 Feet (Please Specify):
(Horizontal)  :  10 – 20 Feet : 20 – 30 Feet : 30 – 50 Feet : 50 – 70 Feet  : >70 Feet (Please Specify):
 
7. How many Bends are required?
  : One   : Two
 
8. From how many pickup points material to be vacuumed?
  : One   : Two
 
9. Material to be Vacuumed from:
  : Fiber   : Plastic or Metal drums   : Boxes   : Bulk Bags or Flexible IBC’S
  : Paper or Plastic bags   : Large box (Gaylord)   : Storage Hopper or Silo
 
10. What is the required feed rate?
  : 50 – 300 Kg/Hr   : 300 – 500 Kg/Hr   : 500 – 800 Kg/Hr
  : 800 – 1200 Kg/Hr   : 1200 – 1600 Kg/Hr   : 1600 – 2000 Kg/Hr
  : 2000 – 3000 Kg/Hr   :  > 3000 Kg/Hr    Please Specify :  
 
11. How many Discharge points will material be delivered to?
  : One   : Two    Please Specify :  
 
12. How much headroom do you have over equipment to be fed?   
 
13. Will our equipment be subjected to fumes, Heat or Vapor emitted from the equipment being fed?
  : Yes   : No    (If Yes) Describe:  
 
14. Our Equipment is to be located   : Indoors   : Outdoors
 
15. Have you handled this Product Pneumatically?   : Yes   : No
 
16. What experience have you had in handling this product?
 
17. Please attach sketch of requirement :  
Type The Code *:  verification image, type it in the box