Application Questionnaire

Application Questionnaire
What is your application?*
What is your measurement goal ?
(what are you trying to accomplish)
Current or Preferred Technology for Process Sample:*

UVVISOther
Sample Type:*

GasLiquidSolidOther
How many measurement points?
(number)
Sample Evaluation: Components 1 - 3

If there are more than 3 components please submit an additional form.
Material / Product to be Analyzed:
Component 1
-
Component 2
-
Component 3
Background Component(s):
Component 1
-
Component 2
-
Component 3
Concentration Units (eg. ppm, %):
Component 1
-
Component 2
-
Component 3
Concentration Range (min/max):
Component 1
-
Component 2
-
Component 3
Precision Required (+/-):
Component 1
-
Component 2
-
Component 3
Accuracy Required (+/-):
Component 1
-
Component 2
-
Component 3
Current Analytical Method:
Component 1
-
Component 2
-
Component 3
Availability of the Full Range of Calibration Samples*:
Component 1

YesNo
Component 2

YesNo
Component 3

YesNo
*If samples are to be submitted please DO NOT send until instructed and procedures are provided (MSDS required).
Any samples sent for application review become the property of Guided Wave.
Analyzer Location / Area Classification / Certification
Location:

IndoorOutdoor
Area Classification:

General PurposeClass 1 Div 1Class 1 Div 2
Desired Analyzer Location:

LaboratoryLab Migrating to ProcessAt-Line ProcessIn-Line Process
Certification Required:

IECCSAATEXNoneOther
Other Process Considerations:

ReactorTankPipeRecycleColumn
Compatible Materials:

316 / 316 L SSHastelloyC276Non-MetallicMonelOther
Sample Conditions
Is the process single phase?

YesNoOther
What is in the sample stream?

Bubbles / AirSolids / ParticulatesOtherOther
Viscosity (cps):
pH:
Flow (L/m):
Temperature(C): Normal
Temperature(C): Minimum
Temperature(C): Maximum
Pressure (psig): Normal
Pressure (psig): Minimum
Pressure (psig): Maximum
How Often Do You Need Results?
(Measurement Frequency)
Sampe Interface and Fiber Optic Cable Requirements
Sample Interface Needed:

Direct Insertion (In-Line)Flow Cell for Side StreamOther
Sample Conditioning Needed:

YesNoUnknown
Distance From Analyzer to Measurement Point (meters)
Contact Information
Name*

First NameLast Name
State/Provience/Country*
Please provide your location so me may quickly direct your request to the local support team.
Email*
example@example.com
Phone Number

Area CodePhone Number
Company Name and Address

Company

Address

CityState / Province / Country

Postal / Zip Code
Budget Information / Other Techniques / Comments

Please provide additional information to help us respond accordingly
Basis for Purchase:

Save Analytical Cost/TimeBetter Precision / Product QualityHigher Product YieldBetter SafetyR&DOther
Purchase Decision:

Immediate3-6 Months6-12 MonthsNext Budgeted YearOther
Currently Budgeted:

YesNoOther
Others Involved in Decision?
Other Devices and/or Techniques being Considered?
Comments:
Should be Empty:

Application Questionnaire

Sample Evaluation: Components 1 - 3

Analyzer Location / Area Classification / Certification

Sample Conditions

Sampe Interface and Fiber Optic Cable Requirements

Contact Information

Budget Information / Other Techniques / Comments