Suffix:

First Name:

Last Name:

Company:

Address:

City:

State/Province:

Zip:

Country:

Phone:

E-mail:

* Required fields

Material Name to Be Fed or Discharged:

Contact Material for Machine:

Voltage requirements:

Explosion Hazard (Operating condition):

Applied Pressure:
(Pressure that would be applied to the New Vibra Screw Equipment)

Contact Material Sanitary Finish:
(Applied to 304 or 316 ss Only)

Material Feed Rate:

Indoors:

Outdoors:

Bag Size (When Filled):

What is the Bulk Bag Unloader discharging to?

Do you need a metering device below the bulk bag filler?

Local to remote Control Communication Output type:

Local to remote Control Communication Input type:

Accuracy Requirement

How will the bag be
put into place:

Bag Weight:

Special Conditions:

Paint Requirements:

Comments: