First Name: 

Last Name: 

Title: 

Company: 

Address 1: 

City: 

State: 

Zip: 

Phone: 

Fax: 

E-Mail Address: 

    Generic Name: 

   Also Known As: 

   Particle Size:  (or) Screen Analysis: 

   Bulk Density:  in:

Moisture Content: 

Handling Characteristics:

     Maximum Rate: 

     Minimum Rate: 

     Average Rate: 

Accuracy Required:  (±% Error)

  Material Source:  (How feeder is supplied with product)

 Feeder Discharge:  (Where product discharges)

Method of Loading:  (Supplying feeder with product)

Desired Method of Changing Feed Rate(s):


Approximate Frequency of Feed Rate Changes:

Product Temperature: 

    Any Temp/Pressure at Feed Inlet: 

Any Temp/Pressure at Feed Discharge: 

Comments:

Batch Range Maximum: 

Batch Range Minimum: 

    Product to be Delivered in What Period of Time: 

Amount of "OFF" Time Before Next Batch is Required: 

Product Contact Surfaces:  Carbon Steel    304SS    316SS

                          Other: 

  Desired Hopper Capacity: 

  Electrical requirements:  (Volts/Phase/Freq.)

If Explosion Proof, Class: 
                    Group: 
                 Division: 

Ambient Temperature: 

Comments:

To Be Mounted:  Locally    Remotely

               Other (Explain): 

Controller Interface (Describe):