Lab Sample Submission Data Form

*Customer Name:

*Address:

*City:

*State:

*Zip Code:

*Contact Name:

Title:

*Phone:

Fax:

 

 

 

 

Sample Identification:

pH:

Color:

Solids Concentration (% by weight):

 

IMPORTANT: Please include analysis of the composition of the sample(s) being submitted or MSDS.

Oil Content (%):

 

CorrosiveFlammableAbrasiveToxic

 

 

 

 

Description of Process, Generating Material:

Type of Separation Required:

Liquid/SolidLiquid/LiquidLiquid/Liquid/Solid

Required Throughput (gallons/day or # of dry solids/day):

Proposed Operating (hours/day):

Proposed Operating (days/week):

Present Method of Separation:

Size of Unit:

Capacity:

Cake Solids (%):

Chemical Addition:

 

 

 

Slurry Characteristics

 

Solids

Composition:

 

Suspended Solids Concentration (% by wt.)

Typical:

Max:

Min:

Specific Gravity:

Avg. Particle Size:

(Provide Particle Size Distribution if available)

 

Dissolved Solids Concentration (% by wt.)

Typical:

Max:

Min:

 

Liquid

Composition:

Viscosity:

Flash Point:

 

 

 

Operating Conditions

Which is more important:

Clarity of LiquidCake Solids

Maximum TTS of Centrate (ppm):

Minimum TS desire (% by wt.):

Do the solids require rinsing?

YesNo

If yes, rinsing objective:

Process Temperature Range:

to °F

 

Do you have to maintain containment or pressure?

 

What are your containment requirements?

 

What materials of construction do you require?

 

What are your electrical requirements?

 

Please provide any additional pertinent information about the slurry or operating conditions.