<p> FLSMIDTH – PNEUMATIC TRANSPORT SYSTEMS</p><p>Fluid Technology, LLC 1315 Nelson St. Unit H Lakewood, CO 80215 Telephone: 303-233-7400 Telephone: 801-268-0600 Fax: 303-233-0093 Internet: www.fluid-technology.com </p><p>QUESTIONNAIRE FOR THE DESIGN OF PNEUMATIC CONVEYING SYSTEMS</p><p>1. NAME: </p><p>TITLE: </p><p>COMPANY NAME: </p><p>ADDRESS: </p><p>TELEPHONE: FAX: </p><p>COPY TO: TITLE: TELEPHON E: </p><p>2. LOCATION OF THE PROJECT</p><p>END USER/LOCATION: </p><p>ADDRESS: </p><p>3. PROJECTED TIME FRAME</p><p>TODAY'S DATE: </p><p>PROPOSAL DEADLINE: </p><p>ESTIMATED PURCHASE DATE: </p><p>ESTIMATED DELIVERY DATE: </p><p>ESTIMATED START-UP DATE: </p><p>1 FLSMIDTH – PNEUMATIC TRANSPORT SYSTEMS</p><p>PROPOSAL STATUS: BUDGET:  FIRM:  PROJECT FUNDED: YES:  NO:  PROJECT BUDGET: </p><p>4. MATERIAL SPECIFICATIONS</p><p>MATERIAL TO BE HANDLED: </p><p>AERATED BULK DENSITY: PACKED BULK DENSITY: </p><p>LOOSE POURED BULK DENSITY: </p><p>ANGLE OF REPOSE: SPECIFIC WEIGHT: </p><p>% MOISTURE: TEMPERATURE: </p><p>SIEVE ANALYSIS: 100% PASSING MESH / MICRONS PASSING MESH / MICRONS PASSING MESH / MICRONS PASSING MESH / MICRONS PASSING MESH / MICRONS (SUGGESTED - 80%, 50%, 20%)</p><p>YES NO MILDLY YES NO MILDLY FREE FLOWING    HYGROSCOPIC    STICKY    ABRASIVE    CORROSIVE    TOXIC    DEGRADABLE    FRAGILE    EXPLOSIVE    OTHER </p><p>5. SYSTEM DESIGN DATA</p><p>BRIEF SYSTEM DESCRIPTION: </p><p>CAPACITY: BATCH / CONTINUOUS</p><p>HORIZONTAL DISTANCE: VERTICAL DISTANCE: </p><p>NUMBER 90 ELBOWS: </p><p>NUMBER OF FEED POINTS: NUMBER OF DISCHARGE POINTS: </p><p>OPERATION TIME: HOURS/DAY DAYS/WEEK WEEKS/YEAR 2 FLSMIDTH – PNEUMATIC TRANSPORT SYSTEMS</p><p>6. DESIRED TYPE OF SYSTEM: DILUTE VACUUM:  DILUTE PRESSURE:  BLOW TANK:  F-K PUMP:  MODU-DENSE:  VACU-DENSE:  HP FEEDER:  AIRSLIDE/AIRLIFT:  OTHER: FULLER BULK HANDLING TO RECOMMEND: </p><p>7. DESIGN CONCERNS: DEGRADATION:  CONTAMINATION:  (IF MORE THAN ONE - COST:  MAINTENANCE:  PLEASE NUMBER IN RELIABILITY:  ENERGY:  DESCENDING PRIORITY) OTHER: </p><p>8. SITE SPECIFICATIONS:</p><p>ELEVATION ABOVE SEA LEVEL: AMBIENT PRESSURE: RELATIVE HUMIDITY: AMBIENT AVERAGE TEMPERATURE: AMBIENT TEMPERATURE RANGE: INSTALLATION: INDOORS:  OUTDOORS:  INDOORS/OUTDOORS: </p><p>9. POWER SPECIFICATIONS:</p><p>HERTZ: 50 HZ:  60 HZ:  LINE VOLTAGE: CONTROL VOLTAGE: </p><p>10. DESIRED EQUIPMENT:</p><p>MATERIALS OF CONSTRUCTION: STANDARD MILD STEEL:  304 STAINLESS STEEL:  316 STAINLESS STEEL:  ALUMINUM:  OTHER: </p><p>ELECTRICAL NEMA RATING: NEMA 4  4X  7  9  OTHER: </p><p>MOTOR ENCLOSURES: OPEN DRIP PROOF:  TOTALLY ENCLOSED:  STANDARD EFFICIENCY:  PREMIUM EFFICIENCY:  STANDARD DUTY:  EXPLOSION PROOF:  CLASS: DIVISION: GROUP: </p><p>PLEASE CHECK IF LISTED EQUIPMENT IS DESIRED:  CONVEYING PIPE  CONVEYING ELBOWS, STANDARD ABRASION RESISTANT FLANGED  CONTROL PANEL, STANDARD OTHER  MOTORS  MOTOR STARTERS  DUST COLLECTOR  DUST COLLECTOR FAN 3 FLSMIDTH – PNEUMATIC TRANSPORT SYSTEMS</p><p> CONVEYING AIR SUPPLY</p><p>OTHER: </p><p>11. COMMENTS/SKETCHES PLEASE ATTACH ANY ADDITIONAL COMMENTS, SPECIFICATIONS AND/OR SKETCHES. </p><p>4</p>