Application Form

Please complete this form to enable us to better understand your needs. We will follow up with you within 48 hours.

1. Your information
Name			Company
Title			Address
City			State	--Please Select-- Alabama Georgia Tennessee
Zip			Fax
eMail			Phone

2. Process

Process Area Requested.

-- Please Select -- Size Reduction Agloeration/Compaction Drying/Thermal Reaction Material Conveying Material Separation/Classification Mixing/Blending Packing/Packaging Process Emissions Weighing/Batching/Feeding

What's the end use of the processed material?

Tablet Capsule Finished Finished Granule Powder Pellets Flake Other

3. Material
Generic Name			Also known as
Appearance	Slurry Crumbly Granules Powder Other
Particle Size
Free Flowing	Yes No	Material Temperature		F   C
Bulk Density	lbs./cu. ft.		Feed Rate	lbs/hr.
Continuous?	Yes   No		Batching?	Yes   No
Moisture Content
Is this material toxic?	Yes   No		If yes, details
Is this material explosive?	Yes   No		If yes, details
Is explosion proof?

4. Application Details
What are the details of the application? What do you want to do? Please describe in detail below: (Material source; Discharges to; Required efficiency; Other requirements)
Are there any specific electrical requirements? Yes    No
If yes, please explain
Materials of Construction/Product contact surfaces: Carbon    304SS    Other
If "Other", please specify
Control Requirements, if applicable.   Local    Remote     Other
If "Other", please specify

5. Testing

Does your application require testing?   Yes    No

Are you interested in witnessing this test?   Yes    No

Preferred Dates