Thanks for your interest in the Autocon line of equipment. This form is designed to speed your request for information. Please fill in the blanks; we will send you the requested information immediately.
Tell us about yourself and your company:
(required information is indicated with
•
)
Request for Information Fill-In Form
•
Your Name:
•
Company Name:
•
e-mail:
Your Phone Number:
Your Fax Number:
Your Title/Position:
Your Company Address:
City:
State/Province:
Postal Code/Zip
Country:
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A brief Description of your Processing Need:
Tell us about any Testing we can do for you:
Formula Name:
When and how will sample materials be shipped?
Safety data sheets to be included?
Yes
No
Requested test completion date:
Is a confidentiality agreement desired?
Yes
No
Dry Constituents: % of total dry constituents by weight;
specific gravity (pounds per cubic foot)
A
B
C
D
E
Wet Constituents: % of total wet constituents by weight;
specific gravity (pounds per gallon); Viscosity @ Temperature
A
B
C
D
E
Desired Through-Put Rate:
pounds per minute
pounds per hour
Please describe any additional notable characteristics,
e.g. abrasiveness; dilatance; thixtropy; cohesiveness; temperatures, etc. of the constituent materials and the mixed formula.
Are you currently batch/continuous mixing?
Yes
No
Do you have any feeding equipment available? If so, please describe:
Which Autocon products would you like information on?
RAD mixers
(Right Angle Discharge)
DID mixers
(Direct Discharge)
Dispersion Pump
Feeders
Other
Notes:
Many thanks
on behalf of the Autocon support team.
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