Johnson Industries Uni-Sampler Coal Sampler Form

For a prompt budgetary quotation, fill out the following information.

Company Name
Company Phone Company Phone - ### - ### ####
Company Address Company Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Contact Name and Title
Contact Phone Contact Phone - ### - ### ####
Contact Email
Company Name of End User
End User Address End User Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
End User Contact Name and Title
MATERIAL DESCRIPTION
Material
If Other, Please Specify
Material Type
If Other, Please Specify
Sampling From
If Other, Please Specify
Number of Trucks/Railcars to be Sampled Per Day
Largest Particle Size to be Sampled (inches)
Final Sample Size Desired (pounds #)
EQUIPMENT REQUIREMENTS & LOCATION
Auger Type
If Other, Please Specify
Sample Collector Required
Temperature range equipment will be operated? (Please Specify F or C)
Power Availability
If Other, Please Specify
Will a Generator be Required
If Yes, What Type of Generator
Will Operator Cabin Require
Are uncrushed samples required
If yes, give reason
Is crushing required
If yes, give top size required
INSTALLATION INFORMATION
Do you require commissioning?
Do you require installation assistance?
Are you needing a turnkey installation quote?