This questionnaire for apc analytics products is to help evaluating the possibility for an on-line elemental belt measurement application, by a fully automated sampling /preparation system.

All information between apc analytics and the Customer is treated as confidential.

The purpose of this document is to make a preliminary design of the application in full co-operation between apc analytics and the Customer.

1. Customer / Plant:

Name:
Street:
Zip-Code:
City:
State:
Country:

2. Contact Person (address only if different to 1.)

Name: / Business Card
Street:
Zip-Code:
City:
State:
Country:
Phone
Fax
Mail

3. Proposed Application

Proposed application
Number of sampling points
Flow Sheet enclosed / Yes / No
Desired sampling frequency
Miscellaneous

4. Short Description of Material

Sample appearance / Dry / Wet
Particle Size / Max [inch]: / Min [inch]:
Max [cm]: / Min [cm]:
Chemical Data / Main elements or oxides of interest:
Chemical Ranges for each element of interest and for the main components in the material / Max: [ppm,%] / Min: [ppm,%]
Moisture content:
Miscellaneous

DESCRIPTION OF THE MATERIAL TRANSPORTATION SYSTEM AT DESIRED INSTALLATION LOCATION(S)

Location of proposed sampling point /
(i.e. crusher / transfer point)
Raw Material transportation method /
(i.e. truck / conveyor)
Conveyor Characteristics / Tons / hour:
Dimensions:
Belt- Speed:
Covered by a rain protection?: Yes No
General conditions:
Temperature Range / Max [°C]: / Min [°C]:
Max [°F]: / Min [°F]:
Already existing sampling system ? (short description)
Miscellaneous

Purpose of application

Who is using the information given by SOLAS
In which location(s) the analysis information is needed ?
What is the purpose of the Online-Analysis
Miscellaneous

Interfaces / Supply

Available Electricity / Voltage [V]:
Frequency [Hz]:
3 Phase system + Grounding:
Compressed air available ? / Yes No
Pressure [bar]:
Distance to control room (where the analysis data are needed) / Distance:[km] /[m] /[ miles] /[feet]
Ethernet connection existing: Yes [mbit]: No
Visualisation system of SOLAS required in control room / Yes / No
Miscellaneous

^

Page 1 of 4