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PAC Application Data Form (ADF)






Customer Contact Information
First Name:
Last Name: *
Customer Title:
Phone:
Fax:
Cell:
Pager:
Email: *
Company:
Division/Site:
Address:
Address (con't):
City:
State:
Zip:
Country:
How did you hear about us?
 
Trim System Info: (email birdseye sketch and AutoCAD drawing where possible to get-facts@airconvey.com)
Trim sample sent?: yes No
Type of Trim producing machine:
Waste configuration
edge trim
center trim
bleed trim
die-cut
matrix
No. of machines
Web width Min  
Max
Approx. distance between machines/ft.
Line speed(s)
Waste to:
compactor
baler
open container

Waste type:
pressure sensitive (PSA)
not PSA or tacky
adhesive laminated

Trim Width(s): Min  
Max
Trim Thickness(es)
Granulation throughput in lbs per hr
Total # of trims per machine
Oscillating ? Constant
If oscillating, what range
Electrical Voltage
Elec. Freq.: 50 HZ 60 Hz
From pick-up to discharge/ft. horizontal vertical
# of bends in Main Line

How handling now
manual
winding
venturi
central
other

Quote needed by:
Drawing required with quote Yes No
Additional Comments:
What is 3 + 5? *

* - Denotes Required Field


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