|
 
|
| |
(*) required fields |
| Company: |
* |
| Division: |
|
| Street: |
|
| City: |
* |
| State: |
* |
| Zip: |
* |
| Name: |
* |
| Title: |
|
| Phone & Ext: |
* |
| Fax: |
|
| eMail Address: |
* |
| Quantity Required: |
|
| Conveyor Style: |
|
| W. Conveyor Width (In.): |
|
| X - Infeed Length (In.): |
|
| DH - Discharge Height (In.): |
|
| D - Incline Angle, If required (degrees): |
|
| HH - Hopper Width, If required (In.): |
|
| Type of Operation: |
|
| Type of Material to be conveyed: |
|
| Shape of Material: |
|
| Size of Material (Largest Dimensions) (In.): |
|
| Gage of Material: |
|
| Alloy or Composition: |
|
| Temperature of material(Degrees F): |
|
| Rate of production(pcs or lbs/hour): |
|
| Is this a wet or dry application? |
|
| If wet, describe liquid type: |
|
| GPM of liquid onto conveyor inlet: |
|
| If submerged how deep? |
|
| Does application require receiving hopper? |
|
| What is required motor voltage? |
|
| Are Casters Required: |
Yes No |
| Paint Colors (Enamel /std) |
|
| Special Paint Color |
|
| Non-standard Paint Type – Epoxy, Imron, Urethane, etc. (add $295 per conveyor) Please Specify |
|
| Additional comment : |
|
| Attach a File |
|
| |
|
