This form is a vehicle for you to convey your needs, explain your application and site requirements/limitations. It is a critical first step in the proposal


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NameThis form is a vehicle for you to convey your needs, explain your application and site requirements/limitations. It is a critical first step in the proposal
A typeDocumentation

Request For Automation
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This form is a vehicle for you to convey your needs, explain your application and site requirements/limitations. It is a critical first step in the proposal process. Please read carefully and fully complete this form. Thank you.


FOR CLEMCO INDUSTRIES USE ONLY

Opp#      

Estimate#      

SP #      




Action Requested:

Customer to indicate approval of data submitted in this document

Customer signature required on initial request

Date

     

     

 Sample Processing

 Budget Estimate

 Formal Quotation
 General Arrangement Drawing Required?

(offered for formal quotation of engineered product only)

Funding Status: Budgetary Approved  Specify Dollars Available $      Estimated Purchase Date (mo/yr)      



Distributor Company Name     

Customer Company Name      

Dist Contact     

Contact/Title      

Address     

Address     

City/State/Zip     

City/State/Zip     

Email      

Email      

Phone:

     

Cell:

     

Fax:

     

Phone:

     

Cell:

     

Fax:

     




Reason For Equipment Quotation

 Replacement

 Product Improvement

 New Process

 Cost Reduction




Application

 Peening

 Descaling

 Finishing

 Cleaning

 Deburring

 Ra Finish

 Bonding

 Appearance

 Paint Stripping

 Other ______________________________________________________________________________

Provide additional information (i.e. peening intensity, Ra finish requirements etc.) _________________________

__________________________________________________________________________________________




Specific Parts to be Processed / Number of configurations to be processed

Name item(s) and describe each. Provide details/drawings for all sizes/configurations. Attach separate document if needed.

Number:      Description:____________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

LENGTH

DIAMETER







MAXIMUM

MINIMUM







MAXIMUM

MINIMUM



















     

     







     

     







For pipes or tubes




WIDTH

WEIGHT

INSIDE DIAMETER




MAXIMUM

MINIMUM







MAXIMUM

MINIMUM







MAXIMUM

MINIMUM







     

     







     

     







     

     




HEIGHT

OTHER

OUTSIDE DIAMETER




MAXIMUM

MINIMUM







MAXIMUM

MINIMUM







MAXIMUM

MINIMUM







     

     







     

     







     

     







Quantity of Parts

Indicate number of parts in a typical batch run      




Production Rate Objective

Number of Parts :      

Per  Hour Day  Week  Month

Number of Shifts Per Day:      

 One Two  Three  Other, specify ______________________________________________________




Material to be Processed

 Steel

 Plastic

 Stainless

 Zinc

 Aluminum

 Copper

 Brass

 Other, please listed _______________________________________________




Current Processing Method

Describe __________________________________________________________________________________________

Current Parts Per Hour Rate:      




Coverage  Partial  Masking Required 100%  Pipe Interior  Pipe Exterior

Describe partial coverage and masking requirements. ________________________________________________________

__________________________________________________________________________




Media

Recommended by Distributor To be determined by Clemco Sample Processing




Media Size







Media Size

 Glass Bead

     




 Steel Shot

     

 Alox

     




 Steel Grit

     

 Soda/BiCarb

     




 Plastic

     

 Ceramic

     




Other, please list ____________________________________




System Type/Material Handling

 Recommended by Distributor  To be determined by Clemco Sample Processing

 Pressure

 Suction

 Indexing Turntable

 Continuous Turntable

 Split Belt Conveyor

 Straight Belt Conveyor

 Magnetic Belt Conveyor

 Magnetic Over/Under Conveyor

 Modified Standard (see below)

 Robotic Blast

 Robotic Load/Unload




Description of Modified Standard:

Custom Paint Color

 Yes  No Paint Specifications ______________________________________________

Should Quote Include Fixturing?

 Yes  No (If Yes, provide parts and/or part drawings for every part size/configuration.










Describe Process Interface

Prior to this process ______________________________________________________________________________

Subsequent to this process ________________________________________________________________________

Compressed Air Supply




Available      cfm

Limited To:       at       psi

Electrical Supply Available

 230V, 3PH, 60 HZ

 460V, 3PH, 60HZ

Other,       V       PH       HZ

Hazardous Location? Yes  No 

If yes, class       division       group      

Dust Collector

 Rotary Air Lock Requred

 Explosion Venting (only when dust collector can be located outdoors)


Noise Level Requirements? Yes  No  If yes, specify noise level in decibels      

Space Limitations For Equipment

     

X

     

X

     




Length




Width




Height




Interest in a visit to our facility in Washington MO for Sample Processing?  Yes  No

Time frame or specific date:      

Submit RFA Please attach relevant part drawing(s) or drawing depicting space layout requirements.


NOTE For sample processing, if production rate estimate is required, please send a minimum of a dozen parts for thorough automation processing evaluation.
IMPORTANT! When sending parts, send an example of acceptable part to demonstrate what blasting process must achieve. Include a labeled blueprint or sketch (when available). If process requirement differs from the sample provided, please describe fully.
If for any reason, parts are not processed, advise disposition

 Dispose of parts  Return parts


Unless otherwise specified below, processed parts will be returned to the Distributor.

Company Name      




Address     

City/State/Zip     

Attention     

Title      

Phone      

Email      

Special Instructions/Requirements (Attach separate sheet if necessary)










FOR CLEMCO INDUSTRIES USE ONLY Opp#       Estimate#       SP #      















Clemco Industries Corp. One Cable Car, Washington, MO 63090 (636) 239-4300 FAX: (800)726-7559

® 2013 Clemco Industries Corp. March 2013 22664


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