INDUSTRIAL DATA FORM
Welcome.
We appreciate your interest in our products and will give your application our prompt attention. Please fill in the following data form and then hit send when complete.
Date
*red labeled items are required.
How did you find us?
Select
Have your literature
In a magazine
Search Engine
CDROM
Other
Firm / Organization
Company Type
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Manufacturing Plant
Industrial Wastewater Plant
Treatment Plant
Waste Processor
OEM
Consultant
Student
Other
Pretitle
First
Last
Title
Address1
Address2
City
St/Prov
ZIP Code
Country
Phone
Fax
Email
Website
Installation Name/Location
Application Type
Select One
SOLIDS
FLUIDS
Project Status
Select One
Immediate Need
Future Budgeting
Planning Stage
Bidding
Other
Machine of Interest
Select One
Pipeline Delumper
Delumper L
Delumper LP
Delumper L S4
Delumper DC1200
Delumper Twin LP
Delumper HM
Vulcanator
Definer
Super Shredder
Supreme Roll Mill
Spiralift SL
Spiralift SR
Don't Know
Other
Specific Model/Description (If known)
Input Lumps size (Max., Avg. and Min.)
Desired Output Size
How critical is this output size requirement?
Solids
Description/Similar to:
Capacity
Units
Select
lb./hr.
lb./min.
m
3
/hr.
ft
3
/hr.
ft
3
/min.
Other
Lumps (%):
Material Is :
Hazardous
Caustic
Mild
Corrosive
Non-Hazardous
Bulk Density (lbs./ft.):
Solids are:
Crumbly
Friable
Brittle
Strong
Hard
Soft
Wet
Dry
Moist
Heat Sensitive
Rubbery
Sticky
Wax Like
Abrasive
Agglomerated Fines
All Lumps
Fluids
Fluid Carrier Containing Solids:
Fluid Flow Rate
Velocity
Pressure
Vacuum
Head of Slurry
Viscosity
Density
Temperature
Permitted Pressure Drop
System
Pipe Size
Flange Rating
Material Pipe
If not pipe, Connection Sizes
Headroom Available
Material of Construction
Select
Carbon Steel
304 SS
316 SS
Other
Motor
TEFC
Explosion Proof
Cycles
Volts
Phase
Need:
Please call
Quote
Budget
CDROM
Specification
Drawings
Literature
Controller Required:
Yes
No
Auxiliary Equipment :
Need Equipment by :
Bid Date:
Application Objective:
Notes
Special
:
Used and Surplus Equipment
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Franklin Miller, Inc. 60 Okner Parkway, Livingston, NJ 07039 -- Tel: (973) 535-9200
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