<p> EQUIPMENT SURVEY FORM </p><p>Surveyor Date: Date Quote Needed Requested Machine Delivery Date Customer</p><p>Address City State Zip Contact Name</p><p>Title E-mail</p><p>Phone Fax</p><p>PURPOSE : Adding new machine Budget price Is Project Funded Replacing old Firm Price</p><p>OPERATION TO BE PERFORMED: Cleaning For Drawing, for coating Deflashing Descaling, Removing Cleaning before inspection Deburring rust Removing Sand Reconditioning Surface Preparation Removing impurities Peening Other</p><p>PARTS TO BE BLASTED : Forging Carbon Steel Stainless Steel Die Casting Steel Casting Grey Iron Aluminum Non-ferrous Rubber Plastic Concrete Machined parts Heat treated Weldment Others Description Largest Smallest Length</p><p>Width</p><p>Height </p><p>Weight</p><p>Temperature </p><p>Type of parts: Ex. Crankshafts, Connecting rods, Brake parts....______</p><p>1 Process Before Blast Shakeout Degate Fabrication Heat Treat Paint Casting Grinding Deflash Other </p><p>Process After Blast Heat Treat Paint Shipping Machining Fabrication Other Grinding Inspection Other</p><p>Surface Contaminants Prior to Blast Rust Sand Powder Coat Pitted Flashing Heat Treat Scale Paint Oil/Grease Other </p><p>Finished Requirement Commercial SSPC-6 Sand Removal Coverage Near White SSPC-10 Surface Profile RA/RMS White SSPC-5 Arc Height Other</p><p>SURFACE TO BE CLEANED : Peripheral Surface Internal Surface Front Rear Hole Outside Others</p><p>ABRASIVE : Description Size Hardness Steel Shot Steel Grit Cut wire Others </p><p>PRODUCTION REQUIREMENTS: - Parts per hour: ______Hooks per hour: ______- Feet per minute: ______Hours per shift: ______- Pounds per hour: ______Shift per day: ______- Cycles per hour: ______Days per week: ______Others requirements: ______</p><p>WORK HANDLING - Coyote to Provide______Customer to Provide______- How is the work brought to the Blast Machine? Eg. Forklift, Conveyor, Etc. ______- How is the work taken away from the Blast Machine? Eg. Forklift, Conveyor, Etc. ______EQUIPMENT REQUESTED BY CUSTOMER: 2 Type Contents 1 Spinner Hanger Capacity ( hook/hr) Load ( pounds/hook) 3 Table Table diameter ( in) Loading capacity ( Pounds) 4 Barrel Blast Capacty ( Cu Ft) 8 Air Blast 9 Other </p><p>DUST COLLECTOR REQUIREMENTS : Existing Unit: New Unit Requested: CFM Available: Total CFM Needed: - Distance from Blast Machine: ______</p><p>ELECTRICAL ESPECIFICATION: Operating power 230 volts 460 volts Other</p><p>Control 110 volts 220 volts Other</p><p>Operation & Control Panel Machine Mounted Remote Other</p><p>Specific Customer Requirements</p><p>LOCATION TO BE INSTALLED:</p><p>- Available height ( ) Feet above floor ( ) Entrance size ( )</p><p>- Available installation space: ( - ) </p><p>COMMENTS: ______</p><p>Parts & Machinery for the Abrasive Blast Industry</p><p>27301 East 121st Street • Coweta, Oklahoma 74429 • (918) 486-8411 • Fax (918) 486-8412 www.coyoteparts.com • E-Mail: [email protected] • Toll Free: (877) 659-8040</p><p>3</p>