June 18, 2013
Gow-Mac
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Please fill in as much information as possible. Items in red MUST be filled in before a quotation will be generated for you. If you need assistance, please call us and an applications engineer will be happy to assist you.
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Purpose of Inquiry: Purchase     Budget
Best time to contact me is between:
M    T     W    Th    F
Need is: Immediate     3-6 months     6-9 months
9-12 months     long term
 NamePhone
End User
Technical Contact for questions
1. Is this a standard method, i.e., ASTM, USP, EPA, etc.? Yes     No
If yes what is the method number? a.
b. Gaseous      Liquid
If no, give brief description of application:
2a. SAMPLE - Chemical Composition: list all components of interest
 Amount
Component NameChemical Formula%ppmppb
2b. SAMPLE - Chemical Composition: list all components present but NOT of interest
 Amount
Component NameChemical Formula%ppmppb
3. Sample Method
Manual: syringe gas sample valveother (specify)
Auto-sampling: liquid auto-sampler automatic gas sample valve
4. GC Detectors Required (if known)
TCD FID DID Other (specify):
PDI FPD Not sure 
5. GC Columns Required (if known)
Packed     Capillary
 LengthDiameter% liquid PhaseSolid SupportMesh
a)
b)
c)
6. Laboratory installation? Yes     No
7. Hazardous area classification at GC? Nonhazardous      Hazardous
If hazardous, Class Div Group
8. Power Available: VAC     Hz
9. Do you require data handling? Yes      No
If yes, explain requirements:
10. Additional Comments:

 

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277 Brodhead Road
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