Your Name: |
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Title: |
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Position: |
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Company: |
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Address: |
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City: |
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State: |
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Zip: |
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Country: |
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Tel: |
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Ext: |
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Fax: |
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Best time to call: |
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AM / PM: |
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E-mail address: |
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Preferred method of contact: |
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First contact date: |
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Response expected by: |
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Scheduled install date: |
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Drawings of equipment: |
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Type of drawing: |
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If CAD What type of File?: |
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Photographs of equipment: |
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What are the reasons for customer's change in belt?:
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What are the perceived benefits of CG for their process?:
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What do they like about their current belt?:
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What is their current belt life?:
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CompactGrid drive system may protrude through the surface of the belt. Will this 3/16: |
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Length: |
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Width: |
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Type of present belt: |
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If plastic belt: |
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Series #: |
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Part #: |
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If metal belt: |
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Laterial pitch: |
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Linear pitch: |
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Wire diameter: |
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Operations performed: |
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Rod gauge: |
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Mfg. of present belt: |
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Support configuration: |
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Material: |
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Does the belt have flights?: |
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If so: What is the type?: |
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What is the material?: |
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If Other What Material: |
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What is the Height? (in): |
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Elevation: |
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Degree: |
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Speed of belt: (FPM): |
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Speed of belt: |
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Type of product(s) being processed:
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Size of product: Length: |
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Size of product: Width: |
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Size of product: Height: |
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Shape of product: |
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Weight of product: LBS: |
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Belt loadng: lb/ft: |
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Temperature of product: |
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Physical characteristics: |
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Do you have abrasive materials present (i.e sugar, crumbs, grits, salt, breading)?: |
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If yes what?: |
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Method of loading: |
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If Other: |
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Operations time: Hrs/Day: |
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Operations time: Days / Wk: |
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Overall machine length: (Infeed to discharge): |
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Drive location: |
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Drive method: |
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If Other: |
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Shaft diameter: Drive: |
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Shaft diameter: Idle: |
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Shaft diameter: Revers Bend: |
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Sprocket or roller diameter:Drive: |
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Sprocket or roller diameter:Idle: |
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Sprocket or roller diameter:Reverse bend: |
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Sprocket or roller diameter:Tension Take Up: |
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Tension take-up type: |
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Build: |
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Manufacturer: |
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Model Number: |
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Mfg Date: |
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Condition of Machine: |
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If Poor, Explain: |
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If a multi-tiered conveyor, are they independent drives?: |
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Are the shafts fully keyed?: |
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Does equipment have: |
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Nose bars: |
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Material: |
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Please mark all conditions present in operation: |
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Type of cleaning agent used on belt: |
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How often are belts cleaned?: |
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Send me a copy
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 Required field
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