Discharger Info Request Form

Customer:

Address:

Date:

Completed by:

Tel:

Fax:

BULK BAG

What is the side seam height of the tallest bag to be emptied?

inches

What is the side seam height of shortest bag to be emptied?

inches

Is the bag lined, if so

__ loose __ tabbed __ glued __ form fit

How far from the end of the outlet spout does the liner extend?

_____ inches

What are the bag base dimensions?

______ x ______ inches

______ x ______ inches

______ x ______ inches

How are the loops sewn?

  __ 4 corner __ cross corner

Outlet spout dimensions?

LENGTH ____ inches
DIA_____ inches

If no outlet spout?

  __ sealed __ bottom __ porthole

What is maximum headroom available?

  __ ft. __ inches

INGREDIENTS

What ingredient(s) is/are being discharged?

1.________________________________

2. _______________________________

3.________________________________

What is flow characteristic? (see chart)

M

------------------------------                              
|                              

Is mild steel acceptable for contact parts?

  __ yes __ no

M1 Free flowing pellets only

M2 Free flowing, granular or powder (not pellets) eg. salt, dry pet food

M3 Moderate to good flowing powders eg. dry refined sugar, plastic powders, dry starch, baking soda

M4 Sluggish flowing eg. talc, wheat flour, moisturized starch, baking soda

M5 Sticky, difficult flowing eg. oat, soya flour, pigments, soda ash, titanium oxide

M6 Floodable eg. lo fat milk powder, hydrated lime

What is ingredient bulk density (TAMPED)?

lbs/cu. ft.

What is ingredient bulk density (UNTAMPED)?

lbs/cu. ft.

Is ingredient toxic/does it need to be hygienically handled?

  __ yes __ no


APPLICATION

What will the filled bag be loaded by?

 

__ hoist
__ fork
__ truck
__ monorail

How much room needed between bag outlet and floor?

______ inches

Does the application need explosion proofing?

  __ yes __ no

What will the discharger be emptying into?

 


WEIGHING

Does machine have to batch directly from the bag?

__ yes __ no

 

Fax your completed form to: 905-795-9654
or mail it to:
1815 Meyerside Drive, Unit 1 Mississauga, ON L5T 1G3, Canada

If you need help with this form please call us at: Toll Free 1-800-736-5739
Telephone 905-795-9696

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