Equipment Interest*Batch MixerContinuous MixerScrew ConveyorHeating / Cooling ConveyorName First Last Company Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail HiddenDate MM slash DD slash YYYY Material Description Industry Material Characteristics (Pick all that apply) Powder Slurry Cake Sticky Abrasive Free Flowing Liquid Toxic Explosive Friable Corrosive Other Has processing equipment been used previously for this material? If yes, describe (pros & cons)New or Replacement New Replacement Bulk Density (lbs./cu.ft.): Flow problems: Material inlet temperature: Material outlet temperature: F C HiddenSeparate pages start hereConveyor Model Tubular Split-Tube U-Trough Unsure Capacity Required (lbs/hr or kg/hr)Mixer production rate: Mixer batch size: Target cycle time: Mixer production rate: Mixer batch size: Target cycle time: Agitator type: Ribbon Paddle Intermittent ribbon Other Paddle type: Solid Loop Abrasion resistant Unsure Construction: Product Contact Carbon Steel 304 SS 316 SS Other Construction: Non-Product Contact Carbon Steel 304 SS 316 SS Other Interior Mill Finish 36 grit 60 grit 80 grit 120 grit Other Exterior Mill Finish 36 grit 60 grit 80 grit 120 grit Other Covers Bolted Hinged Grating Discharge Knife Gate Butterfly Ball Plug Valve Drop-Bottom Doors Manual Pneumatic Dump Tank Other Shaft Seal Mechanical Single Lip Double Lip Pack Gland Split Gland Air Purged Gland ElectricalVoltageCyclePhaseArea Classification Jacket None Hot Water Cold Water Steam Oil Liquid Add Open Line Spray Nozzle Manifold Do agglomerates form during mixing? Yes No Do agglomerates need to be reduced? Yes No SizingInlet HeightDischarge HeightHorizontal Distance to Convey How is the unit loaded? Hopper Capacity Are there facility clearance restrictions?Is auxiliary equipment needed for loading/unloading?Sanitation Requirements Is testing required? No Yes, on site Yes, at S. Howes Yes, equipment rental Other comments:CommentsThis field is for validation purposes and should be left unchanged. Δ
