[Print Form]
Company name:  Contact name & Title
Address:   Phone No:
Email:   Fax No:
1. Location of container?   Indoor Outdoor
2. Is there an elevator to the top of the container?   
3. Structure of container:  Steel Concrete Other:
4. Is there a liner, protective lining or coating inside ?:  Yes No
If yes, please describe:   
5. Please provide measurements of the container:
Height from ground level to top floor:     Diameter   Container height 
If the container is not round      Width:  Length
Is there a cone - Slope degree of the cone :    
6. What is the full capacity of the container?  (tons)  
7. Which best describes your company's problem?
7. Please provide number of openings on the top floor, their locations & sizes:
8. Name of material or product:    9. Is material toxic?  Yes No
   If yes, please describe: 
   10. Is material explosive?  Yes No
   If yes, please describe: 
11. Please indicate the hardness of the build-up and the force required to loosen the material (please check all hardness of material that apply to you) :
Shovel Hard Pick Hard Rock Hard
Light Force Jackhammer Force Sledgehammer Force
12. How many tons of material have to be removed?    (Tons)   
13. What is the discharge capacity?  ( tons per hour)  
14. Number of discharge values or gates. (Note size and Type):  
15. Are all gates operational?:  Yes No
If no, please describe:   
16. Are there instruments or other objects inside the container besides material ?  Yes No
If yes, please describe:   
17. What's the distance from the compressor's
location to the container's top?
(Length of hose required):   
18. Estimated project date:
19. How many days is the container available for servicing?
Please provide any additional information you feel we should know

 

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