Metal Removal

Company Name

Contact Name

Your Email

Phone Number

Fax Number

Customer Expectations and Blend Formula

Type of Metal Contaminate

Quantity of Material

Blend Components
Uniform Pellets Powder Flake Other 

Material Name

Resin Type

Color

Inbound H20


Final H20 Specs

Max:

Target:

Low:

NA 


Bulk Density

Particle/Pellet Size

Samples Required

Liner Type

Labeling

Special Instructions/Misc. Information

Any sample must be accompanied by the appropriate MSDS.

Ancos will require a 1-lb visual sample for process evaluation. Larger subsequent samples may be needed for cost evaluation.

All fields must be completed. If an area is not applicable, please write in N/A. If a field is incomplete, Ancos will not be responsible for said property.