This form can be filled out online, or printed and faxed to (860) 774-7532.

Date		Inquiry Number
Quote Due
Company
Address
Attention		Title
CC		Email
Phone		Fax
PARTS DESCRIPTION
Part Name		DWG/PN#
Parts Supplied:	Prototype	Production	Not Available
Print Supplied:	Prototype	Production	Not Available
Part Condition:	Dry	Oily	Flash, Burrs
Part Orientation
FEEDER BOWL SPECIFICATIONS
Actual Machine Cycle Rate PPM		Special Discharge Height
Requested Feeder Feed Rate PPM		Quick Dump Yes      No
Rotation CW     CCW     TBD		Back Pressure Yes      No
Number of Discharge Tracks		Air Permitted Yes     No
Distance Between Centers		Bowl Coating Yes     No
Discharge Angle Horizontal Down from Horizontal		Type of Coating AFM Recommendation
SOUND SPECIFICATIONS
Sound Enclosure Yes     No		Sound Level DB MAX
BULK HOPPER
Cubic Feet Required		Quick Dump Yes     No	Casters Yes     No
Hours of Storage Required		Stainless Steel Bin & Tray Yes      No
Mounting Table     Floor		Elevator Type
Low Profile Yes     No		Other
HEAVY DUTY TABLE
Common Baseplate Yes     No		Pedestal or Legs Pedestal      Legs
Discharge Height part running surface to floor
TRACKING/INLINE
Type Vibratory      Gravity      Conveyor      Tube
Inline Length inches		Number of Tracks
Distance Between Centers inches
Material Stainless Steel      A-2 Hardened & Plated Other
CONTROLS
Photoelectric Sensor High Track     Low Track		Sensor Type Std Banner Q45 Other
Voltage		Htz
MECHANISMS
Description
PAINT SPECIFICATIONS
Paint Gloss Black     Other
SPECIAL SPECIFICATIONS AND COMMENTS
Please have sales person call to discuss application.

 

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