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Cyclonaire Test Request
Important - MSDS required for each material
***Material may be refused without MSDS***

Customer Data:
Today's Date:
Company:
Key Contact:
Address:
City:
State: Zip:
County:
Country:
Phone:
(include area code)
Fax :
Email Address:
List Test
Attendee(s):

Application Data:
Product Source: Destination:
'horiz. + ' V with 90-degree elbows
Convey Rate pph
Recommended Materials of Construction: CS 304SS Other

Material Data:
Material Name:
Bulk Density:
pcf
Particle Size:

Moisture Content:
%
Is Material: Hygroscopic Corrosive Abrasive
Explosive Toxic

Shipping Instructions:
Return Product to:
Attn:
Freight Terms:
Freight Collect or Pre-Pay & Add
Return Authorization #:
If Pre-Pay & Add:
Preferred Carrier
Account #
If no carrier specified Purchase Order #
Product Shipping Class

***Please Include Hazmat Symbol Information, If Required***


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