Services Corporation
DATA QUESTIONNAIRE

Please take this opportunity to complete and return the data questionnaire (DQ) to receive a no obligation proposal for the service or equipment best suited to your specific application. Upon receipt of your completed DQ, MMSC 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.

     
RETURN TO:   OR FAX TO:
MOLE•MASTER SERVICES CORP.
C/O Request for Proposal
27815 State Route 7
Marietta, OH 45750-9968		   MOLE•MASTER SERVICES CORP.
C/O Request for Proposal
Fax: 740-374-5908
     

Company
Date
Facility
Address
City
State
Zip
Country
Contact
Title
Department
Fax
Phone
Ext
E-Mail
    
Please provide country & city code if outside USA
I. External Vessel Configuration
Name/Number
Date of Construction

Location:

Indoor Outdoor Split Other

Construction Type:

Steel

Welded Bolted Other


Concrete

Slip Jump Stave Other

Wall Thickness:

Elevator to top of Vessel?
Yes No

Capacity and Size
How close can a compressor be located to base of vessel? ft.
Does vessel have stiff arm or other hoist? Yes No
Describe
Is there an in-place dust collection system Yes No
Describe dust collection system
Are there drawings or prints of the vessel?Yes No
Are they attached? Yes No
II. Internal Vessel Configuration
Planned storage capacity tons
Amount of material build-up to be removed tons
Internal Temp °F External Temp °F Internal Humidity %
List any instruments inside vessel
Note any baffles, tubes, inverted cones sections, etc.
Lining or coating material
III. Vessel Discharge/Loadout System
Type Bottom: Flat Cone Sloped Other
Size, shape and number of feeders
Air slides or other fluidizing equipment? Yes No Type:
Type discharge valves or gates (note size)
Vessel feeds a conveyor with tons/hour capacity
(or describe loadout system for finished product )

 IV. Your Problem
Describe your problem below:

Which number is the most representative sketch?

I
II
III
IV

(If none of the options are representative, please sketch one of your own and fax it to 740-374-5908)
Condition of non-flowing material (wet, dry, burnt, etc.)
Duration of build-up
Date of last cleaning
Number of discharge feeders
Number clogged
How high does non-flowing material extend up the walls? ft.
Is there a rathole established? Yes No
What size?
How thick is the non-flowing material?
Estimate hardness of non-flowing material (by comparing to a known material)

 V. Material Information
Name of material
Is MSDS attached? Yes No
Density of material lb./ft.
Particle Size
Is the material hygroscopic? Yes No
Approximate value $/ton
Special Handling Due: Dust Toxic Fire Other
Moisture Content %
If cement, type
 VI. More Information  
Service requested: Cleanout Establish preventative maintenance program Unclog

Structural Inspection Structural Repair
Other

How has vessel been cleaned out in the past?
Approximate time frame and cost of previous cleanouts.
Approx. Time Approx. Cost
How long is vessel available for servicing?
Estimated project date.
VII. Dimensions  
Please attach any additional sketches of the vessel top, bottom, internal structures, feeders or system layout.
A
B
C
H
S 		L
W 		D

Describe roof openings (include location and dimensions).

 

 VIII. Attachments
Please fax a copy of the MSDS material along with any prints or drawings available that clarify the dimensions below to 740-374-5908

 
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27815 State Route 7
Marietta, Ohio 45750 USA
800-322-6653
740-374-6726
Fax: 740-374-5908