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: *

UV VIS
Sample Type: *

Gas Liquid Solid
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

Yes No
Component 2

Yes No
Component 3

Yes No
*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:

Indoor Outdoor
Area Classification:

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

Laboratory Lab Migrating to Process At-Line Process In-Line Process
Certification Required:

IEC CSA ATEX None
Other Process Considerations:

Reactor Tank Pipe Recycle Column
Compatible Materials:

316 / 316 L SS HastelloyC276 Non-Metallic Monel
Sample Conditions
Is the process single phase?

Yes No
What is in the sample stream?

Bubbles / Air Solids / Particulates Other
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 Stream
Sample Conditioning Needed:

Yes No Unknown
Distance From Analyzer to Measurement Point (meters)
Contact Information
Name *

First Name Last 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 Code Phone Number
Company Name and Address

Company

Address

City State / 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/Time Better Precision / Product Quality Higher Product Yield Better Safety R&D
Purchase Decision:

Immediate 3-6 Months 6-12 Months Next Budgeted Year
Currently Budgeted:

Yes No
Others Involved in Decision?
Other Devices and/or Techniques being Considered?
Comments:
Should be Empty:

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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