Drawer Magnet Quotation Request

PLASTIC SERVICES
& EQUIPMENT

Drawer Magnet Quotation Request To request a quote, please complete the following form. We will respond as soon as possible. Remember, the more information you can provide, the faster we can reply.
Contact Information
Your Name:
Job Title:
Company:
Account No:	(If Known)
Mailing Address:
City:		State:	Zip Code:
Country:
Phone:
Fax:
E-mail:
Type of Business:
How did you find us?

Quotation Information

Machine Make:
Model Number:
Serial Number:
Feedscrew Size:
Ounce Capacity:
Make of Hopper:
Hopper Capacity:	(pounds)

Vacuum System Standard System
	Optional Equipment (for Standard System only): Slide Gate Shut-Off Purge Hopper (Right Hand Side) Purge Hopper (Left Hand Side) Discharge Dump Tube on Rear Tapped Hole for Liquid Dispensing System Powder Seat Kit Other
Bottom Flange Dimensions: Operator Side

A:		B:
C:		D:
E:		F:
G:		H:
I:	(bolt size used)

J: Opening:
Round:
Square:
Rectangular:	Front to Back Side to Side

Top Flange Dimensions: Operator Side

K:		L:
M:		N:
O:		P:
R:		S:
T:	(thread size used)Threaded HolesStuds
	Studs will be required if bolt pattern falls on housing body.

V: Opening
Round:
Square:
Rectangular:	Front to Back Side to Side

Other Information:

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