Mole-Master Services Corporation
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Turn to the Turnkey Experts to Solve Your Silo Cleaning Problem

Our objective is to quickly get you the information you need to solve your silo cleaning problem.

We have created the following detailed Data Questionnaire (DQ) designed to help us understand your specific situation and then develop an action plan and estimate for involved services.
To download a printable version of this form, please click here.

Upon receipt of your completed questionnaire, we will provide you with our recommendation for the specialty service or equipment that will solve your problem in the fastest, safest, and most economical way possible.

Note: Please fill out a separate questionnaire for each silo/vessel requiring service.

Don't have time to complete a questionnaire? No problem. Simply call 1.800.322.6653 (U.S.A. only) or 740.374.6726 and you will speak with a person ready to help solve your problem.

 
I. CONTACT INFORMATION   (Required fields are in red.)
Date:   mm/dd/yy
Company Name:  
Facility Name:
Mailing Address:  
Country:  
Mailing City/State/Zip:   /   /  
Shipping Address:  
Shipping City/State/Zip:   /   /  
Contact Name:  
Job Title:  
(For international Phone, Mobile/Cell and Fax,
please include all country and dialing codes.)
Phone Main:  
Phone Extension:
Mobile/Cell:
Fax:
**Email:
**If you would like to receive a digital version of your completed questionnaire, please enter your email address.
Send completed questionnaire to the following additional email addresses:
Email 1:  Email 2:  Email 3:
 
II. PROBLEM DESCRIPTION
Typical Vessel Problems
 
Duration of Build-Up Date of Last Cleaning mm/dd/yy
Cleaning Method Used  
Describe The Problem  
 
III. MATERIAL DETAILS
 
Name and Description  
of Material(s)  
 
Description of the Material (Check all that apply)
           
           
 
Planned Storage Capacity   Tons lbs. Bushels  
Amount of Built-Up Material
to be Removed
  Tons lbs. Bushels  
How High Does Non-Flowing
Material Extend Up the Walls?
  Inches Feet Centimeters Meters
 
IV. VESSEL DETAILS - EXTERIOR
A. Vessel Information
Vessel Name      Vessel Number      Date of Construction    (year)
 
B. Vessel Construction
Concrete  
Steel (check all that apply)  
 
C. Cone Construction


 
D. Vessel Type
Type of Vessel – Please select from images as shown to the below right


 
E. Top View Dimensions
A:
B:
C:
D:
E:
 
F:
G:
H:
I:
J:
K:
L:
M:
N:

Is it divided?:

If divided, please describe

 
F. Side View Type







 
G. Side View Dimensions

A:
B:
C:
D:
E:
F:
G:
H:
I:
J:
K:
L:
M:
N:
O:
 
H. Roof Openings
Number of Openings(How Many Openings):
 

Shape of Openings:

 
Measurements:
A:   
B:   
C:   
D:   
E:   
 
Describe Roof Openings  
Lining or Coating Material  
Air Slides or Other Fluidizing Equipment?  
If Slides or Other Fluidizing Equipment
Exists, Please Describe
 
Type of Roof:
   
If Peaked, Please Provide Degree of Slope:
Is There an In-Place Dust Collection System? Please Describe:
I. Discharge
Number of Discharge Feeders:
Usable Discharge Rate: Tons per hour    Bushels per hour    lbs. per hour
Number of Discharge Feeders
Partially Clogged/Blocked
  Number of Discharge Feeders
Fully Clogged/Blocked
 
Type
       
       

Shape

   
Measurements:
A:   
B:   
C:   
D:   
E:   
J. Material Removal (check all that apply)
     
   
K. Lifting Equipment To The Top (check all that apply)
     
L. Placement
How Close Can a 750 scfm @ 300 psi Truck or Trailer-mounted Diesel Compressor Be Located To Vessel Base?  
 Feet     Meters
V. PROJECT SCHEDULE
 
Start Date mm/dd/yy         Anticipated Start Time  hh:mm  
 
How Long Will the Vessel
be Available For Service?
    Shift Preference (Mole•Master
shifts are typically 12 hours)
 
Is Vessel Available for
Mole•Master to Work Weekends?

Please fax or email a copy of the MSDS material along with any prints, drawings, or photographs available which can be used to clarify the dimensions or help us better understand the facility and problem description. Please also email any related documents to ContactUs@molemaster.com.

Thank you for completing this questionnaire.

Your information will be analyzed by one of our project managers who will prepare a proposal for your review.

If you require immediate assistance, please call our Rapid Response emergency number 1.800.322.6653 (available 24/7 in U.S.A. only).

Fax: 740.374.5908
Email:ContactUs@molemaster.com

 

Reminder: To receive a digital version of your completed questionnaire, please enter your email address in the Contact Section at the start of this form.

Note: Due to email filtering, there is a possibility that you may not receive a return email containing your completed questionnaire. Should this occur, please call us so that we may send a copy of your completed questionnaire.

Thank you.

VI. FINAL STEP

Please enter the following code below very carefully! It must be an exact match.. If you DO NOT enter this information correctly, we may not receive your request!

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