QUESTIONAIRE
GENERAL SPECIFICATION REQUESTED FOR MACHINE

COMPANY :
CONTACT PERSON :
ADDRESS :
PHONE :
FAX :
E-MAIL :
DATE :
PURCHASE EXPECTED IN THE MONTH OF :	MM Jan (1) Feb (2) Mar (3) Apr (4) May (5) Jun (6) Jul (7) Aug (8) Sep (9) Oct (10) Nov (11) Dec (12)
YEAR :	YY 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
PRODUCT :
QTY. OR WT. PER PACKAGE :
PACKING SIZE - WIDTH :
PACKING SIZE - LENGTH :
PACKING MATERIAL :
TYPE OF PACKING :	3 SIDE CENTER SEAL 3 SIDED SEAL 4 SIDED SEAL
COMMENTS :
FUNCTION AND ACCESSORIES
PHOTO EYE REGISTRATION :	YES NO
CODE PRINTING :
CODE PRINTER :
EMBOSSING UNIT, LOCATE ON SEALING JAW :
FILLING METHOD :
VOLUMETRIC ROTARY CUP :
AUGER FILLING UNIT :
PISTON TYPE :
PUMP TYPE :
PRODUCT LOADER FOR FILLING UNIT :	SCREW FEEDER
PERFORATE CUTTING DEVICE :	NO YES
GAS FLUSHING DEVICE :	NO YES
SPARE PARTS :	NO YES
CONSTRUCTION STANDARD, SS#304 OR RUST PROOF MATERIAL FOR CONTACT PARTS OTHERS COATED BY EPOXY ENAMEL.
OTHER :
OTHER FEATURES :