Metal Reclamation Putties Online Site Survey Form

I - User Information

Contact Person Name *

Mobile No :* Email ID :*
Company Name : Address :
Country : State :
City :

II - SITE INFORMATION

i) Equipment/Job Name *

ii) Process Description/Nature of work *

iii) Previously tried alternative methods & Result:  

iv) Damage areas ?
Surface show excessive wear / undulation cm Area Sq.CM

v)Surface Condition:

v(i) Age Of Equipment:* Month/Years
v(ii) Surface Temperature * C/F Continuous Intermittent
v(iii) Surface Stresses Applicable Not Applicable
Pressure Abrasion Impact
Details

v(iv) Surface Load

v(v)Rotary / Dynamic * RPM
Static * Tons/Kgs
v(vi)Surface Substrate: Ferrous Non Ferrous
v(vii) Surface Condition: Dry Wet Damp Oily
vi) List of chemicals, if any (Acids/Altaris/Salt/Solvents/Gas/Hydrocarbons etc.) Applicable Not Applicable
i) Immersion Splash Spillage Intermittent Accidental
ii) Name Concentration % Temp C PH value

vii) Surface Preparation Preference:

Acid Etching Hand Grind Sand Blast
Shot / Grit Blast Scarify Others
viii) Does installation require any Partial / Full shudown ? Yes No Not Applicable
If yes, what are the plans? *
Available Time * Hours/Days for Surface preparation/Application/curing/Inspection

ix) Approximate Budget

III) Site Facilities

Free of cost Chargeable basis
Electricity
Water
Compressed Air
Shelter for materials

Boarding at Canteen Facility

Labour /Bachelor / Dormitory Accommodation

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