Conveyor Questionnaire

Please fill this form in as accurately as possible to allow us to deal with your enquiry more effectively.

For dimensions please specify mm or inches.

Date:

17 May 2008

Client
Address
Address 2
Address 3
Address 4
Post Code
Country
Email Address
Contact name
Phone No.
Fax Number
Location of Conveyor
Type of material to be handled
Density (Lbs./Ft.3)
Particle or lump size
Details of Material
Capacity Required (Tons per hour or cu. Ft/Hr)
Conveyor Type
Horizontal Length (1) (Ft.) First Inlet to Final Outlet
Vertical Lift Height (if inclined) (2) (Ft.)
Or degree Slope
Second Horizontal Length (3) (Ft.)
Second Lift Height (4) (Ft.)
Number if intakes
Position
Intake Length (In.)
Number of outlets
Position
Outlet Length (In.)
If Existing Conveyor, give details
Type of Chain
Case Width (In.)
Case Height (In.)
Sprocket Type
Drive (hp)
D/W Shaft Diameter (In.)
T/E Shaft Diameter (In.)
Please enter the first and last characters/numbers from "4KULXPB40SPTRV4"