EMPIRE ABRASIVE EQUIPMENT COMPANY 2101 WEST CABOT BLVD., LANGHORNE, PA 19047-1893 PHONE: (215) 752-8800 FAX: (215) 752-9373 BLAST ROOM REQUEST FOR QUOTATION FORM DISTRIBUTOR CUSTOMER Name: Address: Name: Address: Contact: Phone # Contact: Phone # Ext # Ext # REQUIRED BLAST ROOM INFORMATION 1. 2. 3. 4. 5. 6. Parts to be Processed: Area to be Processed: Estimated Production Rate: Media Type: Surface Finish Desired: Blast Room Enclosure Type: Media Size: Package (Pre-Assembled) Field Erected -Bolted Welded (std) A. Room Enclosure Size: wide x long x high B. Main Door Size: Full Width Partial Width (doors over 16 ft wide will require oversize permit shipping) Bi-fold Roll-Up Steel or Rubber Drive Thru, one set each end include option Option out **recommended for 20’ rooms and C. Man Access Door: Included as standard longer D. Work Cart With Tracks: 2,000 lb. Capacity - 4’ wide x 6’ long 10,000 lb. Capacity - 6’ wide x 8’ long Other: E. Overhead Monorail Beam: Include Option Weight of Part: F. Side Wall Rubber Curtains: Include Option ** Curtains run from floor to 6’ height G. Exterior Manual Work Station: Include Option 7. Room Floor Type: Pit allowed? yes no A. Screw: Full “U” Shape “H” Shape Cross B. Vibratory: Full “U” Shape “H” Shape Cross (25’ long & less) (longer than 25’) (25’ max Length) ****WEIGHT CAPACITY if FULL FLOOR: C. Media Sweep Chute Media Shovel Chute (requires 42” deep pit) (requires no floor excavation) D. Pneumatic Troughs:Heavy Duty (W Section) Length: 8 ft. 10 ft. 12 ft. Long Pneumatic reclaim can be used with mechanical recovery floor E. Full Air Floor (W trough modules) 8. Media Storage Hopper: 6 1/2 Cubic Foot (standard) 10 1/2 Cubic Foot Large Free Standing Specifiy Size: Page 1 QUOTATION #Q-xxxxx 9. Media Recovery System Type: 10. Operator Blast Equipment: Pneumatic Recovery Bucket Elevator w/ Vibe Air Wash Separator Bucket Elevator w/ Rotary Drum Separator 6 1/2 Cubic Pressure Vessel - One Operator (standard) 10 1/2 Cubic Pressure Vessel - One Operator 10 1/2 Cubic Pressure Vessel - Two Operators 11. Operator Safety Equipment: Standard (Hood, Air Purifier, Air Conditioner & Clothing) Include Option C.O. Monitor (O.S.H.A. requires when breathing compressed air) Include Option Ambient Breathing Air Pump (air conditioner not available) Include Option 12. Room Ventilation System: 50 FPM Cross Draft (standard) Other FMP 13. Electrical System: 230 volt/ 60 hertz/ 3 phase 460 volt/ 60 hertz/ 3 phase 4 Wire—Std with 277 volt lights 575-600 volt/ 60 hertz/ 3 phase—Std with 120 volt lights Special, please specify voltage: 14. Special Requirements: (paint, toxic parts, OSHA noise levels, etc...) 15. Does System have to be built to Customer Specifications: YES NO ============================================================================= Customer’s Equipment Budget: $ Mail Original To: Distributor Type Of Quotation: Firm Budgetary Customer Expected Date Of Purchase: / / Sales Manager Originator’s Name: Date: / / Page 2