For a free, no obligation quotation please complete the form below to the best of your ability. Equipment offerings will be based on this information.

If you do not wish to submit information on-line. Please print this form and fax it to us at 724-452-3250.

CONTACT INFORMATION

Company Name
Name
Title
Address1
Address2
City
State
Zip
Country
Phone
Fax
E-Mail address

APPLICATION SPECIFICATIONS

Material
Bulk Density	lbs./Cu. Ft.
Moisture Content	%
Environment	StandardExplosive
Unit Preference	ElectricAirBallHydraulicTruck
Power Available	120 Volt Single Phase220/440/3/6012V24 Volt Other
Air Available	PSI SCFM
Hydraulic Available	PSI GPM

(Dimensions in FEET Preferred)

Select the figure that best represents your application.. Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 L= W= O= H= D= d= L2=