Company:

Name:

Address:

City: State: Zip:

Phone: Fax: Email:

Material Conditions:

Material:

Weight: Pounds Per Cubic Foot or Kilogram Per Cubic Meter:

Complete Dimensional Information Or Supply Drawings And Photos

Standard of Measurement:	Inches / Feet	Millimeters / Meter
		Length: Width: Diameter: Height:

Type Of Problems:

Describe The Problem:

Current Solution

Method Being Used Now (i.e. hitting with hammer, poking):

Flow Aids Presently Being Used or Used Previously:

How Often And Duration Of Current Method Being Used:

Effect Current Method Has:

Power Availability
Power Preference:	Electric Pneumatic
Electric Requirement:	Single Phase Three Phase     Voltage:
Explosion Proof:	Yes No     Classification:     ATEX Rating:
Method of Control:	Timer PLC Solenoid Manually
Notes:
Enter Code: