U.S.A. Silo Service, Inc.

1878 Pottmeyer Road

Waterford, Ohio  45786  

Phone:   800-510-9101     Fax:   740-749-0111

Our job profile form will be used to define your project needs.  Please be as complete as possible.  For best results, fax or email your completed form.

QUESTIONNAIRE

COMPANY  _______________________________________

FACILITY  _______________________________________

ADDRESS  _______________________________________

CITY  ___________________________________________

STATE    ________________     ZIP CODE  ____________

PHONE NUMBER  _______________________________________

DATE  ____________

CONTACT  _______________________________________

TITLE  _______________________________________

DEPARTMENT  _______________________________________

FAX NUMBER  _______________________________________

EXTENSION  _______________________________________

EXTERNAL INFORMATION

1.  Location:

    _____  Indoor     _____  Outdoor     _____  Split     ______________________  Other

2.  Height and diameter of container:  ________________________________________

3.  Construction Material:

    _____  Steel     (circle)     welded     bolted     other  ___________________________

    _____  Concrete     (circle)     slip     jump     stave     other  

4.  Wall Thickness:     ____________________________

5.  Elevator to the top of container?     Yes  /  No

6.  How close can a compressor be located to the base of the container?

        _________  feet

7.  Does container have stiff arm or other hoist?     Yes  /  No

    Please describe:  ______________________________________________________

8.  Are there drawings or prints of container?   Yes  /  No

Are they attached?   Yes  /  No

INTERNAL INFORMATION

9.  Planned storage capacity __________ tons

10.  Amount of unwanted material buildup ____________ tons

11.  List any instruments inside container:  ____________________________________

12.  Liner or Coating Material:  _____________________________________________

CONTAINER UNLOADING SYSTEM

13.  Type of bottom:

    _____  Flat     _____  Cone     _____  Sloped (degree)  __________________   Other

14.  Number of feeders:  _____     Sizes and shapes:  ___________________________

    ______________________________________________________________________

15.  Air slides or other fluidizing equipment?     Yes  /  No

Type:  __________________________________

16.  Type of discharge valves or gates (note size):  _______________________________________________

17.  Describe unloading system:  ____________________________________________

    ______________________________________________________________________

18.  Please sketch a drawing that represents the nature of your problem:

19.  Condition of non-flowing material (wet, dry, burnt, etc.):  ______________________

20.  Has the container ever been cleaned?     Yes  /  No

21.  How often does it need cleaned?  _______________________

Date of last cleaning:  _____________

22.  Number of discharge feeders:  _____________     Number clogged:  ____________

23.  Is there a flow channel established?     Yes  /  No

If Yes, what size?  _______________

24.  Name of material:  ________________________________

Please attach MSDS:  _______________

25.  Special handling due:

    _____  Dust     _____  Toxic     _____  Fire     __________________________  Other

26.  How has container been cleaned out in the past?  ___________________________

27.  Estimated project start date:  _______________________

"Our Job Begins and Ends with our Customer."

Download a Job Profile Form

General Instructions:  Right-click on the file format of your choice, choose "Save Target As," the download will automatically begin.

"Our Job Begins and Ends with our Customer."

top

email 

web design and hosting by Tessum Business Services