Application Data Form

Application Data Form/Berthold Ash Monitor

Before a quotation can be issued, we should have this form completed.
Company Name
Contact Name
Street or PO Box			Zip Code
City			Phone
State/Province			Fax
Date
eMail

COAL CHARACTERISTICS (at measurement location)
1. Approximate density	lbs./ft.
2. Ballast (ash+water) content	water% high low average
	ash% high low average
3. Iron Components as % of Total Ash: Fe203% range high% low%
	Fe-Sulfur Compnents:
	a. % high% low%
	b. % high% low%
	c. % high% low%
4. Particle size distribution	2" to 3"	%	Maximum sizein.
	1" to 2"	%	Other sizes
	1/4" to 1"	%
	Fines	%
5. Source of Coal:	Single Mine Multiple Mines Truck or Rail Other

INSTALLATION DESCRIPTION:
1. Where is the ash being monitored?
2. Single or multiple belts?
3. On-line belt sampling belt
4. Belt characteristics: material? width?
	belt speedft/min. Variable? YesNo
	tons/hour: high: low: average:
	bed depth: high:in low:in average:in
5. Nature of coal stream:	ContinuousIntermittent
	Cross section: RoundedJagged
6. Is coal stream well mixed, or does ash content vary across belt? MixedVaries
Describe:
7. Location: InsideOutside Lowest ambient temperatureF
8. Location relative to other equipment (cleaning plant, silo, etc.)
MEASUREMENT REQUIREMENTS
1. Why is ash measurement required?
2. Required output:4-20m Amp RS232 for printer For computer
3. Does customer need:	multiple belt measurements?YesNo
	multiple measurement on same belt? YesNo
4. Expected deadlines:	Delivery: Start-up:
Additional Notes

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