Johnson Industries Uni-Sampler Coal Sampler Form

Johnson Industries Uni-Sampler Coal Sampler Form

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

Company Name *
Company Phone * - (###) - ### ####
Company Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Contact Name and Title *
Contact Phone * - (###) - ### ####
Contact Email *
Company Name of End User *
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? *