Silo Cleaning Service Application Data Sheet

Please fill out information below and click "Submit"
Fields with (*) are required

Company:

Street:

Contact:

City:

Phone*:

State:

Email*:

Zip:

Fax:

Date:

(If prints available, disregard)
A ft/m

B ft/m

C ft/m

D ft/m

E ft/m

F ft/m

G ft/m

H ft/m

I ft/m

J ft/m

K ft/m

Number of discharge feeders:

Number of clogged feeders:

Discharge type:
Slide Gate
Rotary Valve
Vibratory
Other

Feed rate:
TPH

Roof Opening:
Square
Round
Rectangle

" x "

Height of lip on manhole:
ft. in.

Thickness of roof:
ft. in.

INFORMATION NEEDED:

Elevator to the top of the container? No Yes Air Slides or other fluidizing equipment? No Yes Inverted cones or baffles? No Yes Describe A working dust collection system? No Yes Instruments or structural supports inside? No Yes Liner or coatings inside container? No Yes Obstructions? Vertical Horizontal (within 5' any direction inside / outside roof opening)		Type of Outlet: 110V 220V 440V Type of Bottom: Flat Cone Sloped Other Air supply available: PSI CFM Type of Vessel: Silo Bin Bunker RailCar Interstice Tank How long is container available for cleaning? Safety Training required? No Yes f/ Hrs Top of Silo: Indoors Outdoors Is roof sloped? No Yes @ pitch / angle Roof Load rating?

Last cleaned: Method used: Material: Estimate of non-flowing material: Planned Storage Capacity: Last cleaned: Method used:		Condition of non-flowing material: Wet Dry Material Temp: °F Moisture % Compaction: Soft (Shovel) Medium (Pick) Hard (Jackhammer) HOW WILL DISLODGED MATERIAL BE REMOVED:

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