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Questionnaire
In order to better evaluate your requirements we ask that you respond to the questions listed below.
* Fields in bold are required
Name
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Company
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Address 1
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Address 2
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City
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State
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ZIP
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Country
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Phone
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Fax
Email
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Please answer the following questions:
1. What duration release is needed?
2. What is the release window (minimum and maximum days or hours for release timing)?
3. What is the temperature of the water in which the release will be functioning?
4. What is the static load the release will be subjected to?
5. What is the dynamic load the release will be subjected to?
6. How many releases are needed?
7. What date are the releases required?
Month:
1
2
3
4
5
6
7
8
9
10
11
12
Day:
1
2
3
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5
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Year:
2017
2018
2019
2020
2021
2022
2023
2024
2025
8. Will the Galvanic Timed Release be in contact or close proximity to other metals?
9. Special conditions/comments: