* required fields
Contact Information:  
     
* Name:
* Company:
Which Site (city/state):
Phone:
Fax:
* Email:
     
Application Questions:  
     
Will you ever have a need to dump drums? YES | NO
     
If yes, do you want to dump the drums forward or left/right? Side Dumping | Forward | Quote Both:
     
What would the lift height (to bottom of drum) would you need? 48" | 96" (2 stage) | 108" (2 stage) | Other
     
Ever have a need to weigh drums for inventory or creating batches? YES | NO | Quote as Option
     
Is this for a Food or Pharmaceutical use where FDA coating or Stainless Steel is required? YES | NO | Quote as Option
     
Does it need to be 'EE" rated for Intrinsically Safe Areas? YES | NO | Quote as Option
     
Will the unit be in a 3 shift operation where battery swapping will be necessary? YES | NO | Its possible
     
Drum Types: Steel Poly Fiber Mauser ?
    55 gallon Drums diameter of 20"-24"
Please select all that apply: Smaller/Larger drums than std 55 gal (please list below)
     
Any specials comments: