Date:      800-332-1590 

Parts Cleaning Specification Worksheet for Aqueous Parts Washers

Please fill out all applicable information.  We will contact you to fill in the details needed to send you a preliminary quote.  Thank you.

Customer Information: Page 1

Company                  

Contact                                                             

Phone                                              

Fax                                                                    

E-mail

Address

City

State / Province

Zip/ Postal Code

Workpiece Information:

Name of item(s) to be cleaned:

Material type of each item:

Maximum Part Size: Approximate Weight:

Length:  Width:  Height:

Throughput per day:   

Contamination to be removed: ( oil, grease, metal chips, dirt, cutting fluids)

Other:

Any hazardous material: Yes  No If yes, please describe:

Unique geometry: (blind holes, critical through holes, cavities) Other:

NOTES:

Customer Preference: Page 2

Facilities: Natural Gas   Propane

Electrical Supply: 220 Volt, 1 Phase       220 Volt, 3 Phase       480 Volt, 3 Phase

Other Voltage / Phase:

NOTES: