Belt Conveyor Questionnaire

Contact Information:

Contact Name*:

Company Name*:

Address*:

Phone:

Fax:

Email*:

Product Description:

Product Packaging:
Plastic
Paper
Cardboard
Aluminium Foil
Metallized Film
Not Packaged

Product Condition:
Frozen
Solid
Thawing
Raw
Sticky
Wet
Dry
Powdered

Dimension Template



Product Dimensions:

Product

Length

Width/Dia.

Height

Weight

Belt Specifications:

Number of Items Across Belt



Product Rate

Products Per Minute

Product Spacing

Width of Existing Belt

in.

Speed of Existing Belt

Feet Per Minute

Product Temp. F

or C

Bulk Product:

Density lbs/Sq. Ft.



Throughput Rate

lbs/hr lbs/min

Operating Enviroment:
Warehouse
Refrigerator
Freezer
Outdoors
Near Ovens

Conditions:
Wet
Dry
Dusty
High Static
Hazardous
Class Div

Temp F

Cleaning Method:
Dry Wipedown
Low Pressure Hose
High Pressure Hose
Caustic Washdown

Conveyor Specifications:

Length:

Width:

Infeed Ht:

Outfeed Ht:

Belt Type:
Plastic Link
Table Top
Wire Belt
Single Ply
Double Ply
Polycord Belt

Describe Existing/Customer Brand Preference:

Mounting Options:
Suspended
Pads
Boltdown Pads
Locking Swivel Casters
Dairy Feet

Controls Location (View From Infeed):
Right Side
Left Side
Remote

Cable Length

Ft

Power Requirements:
110/115-1-60
220/240-3-60
440/460/480-3-60
Special

Interface With:
Metal Detector

Size:

wide by tall,

manufactured by:


Check Weigher
X-Ray
Manual Signal
Other
If other, describe

Reject Direction:
Reject To (view from infeed)
Right Side
Left Side
Discharge at Outfeed End

Reject Device:
Stop Alarm
Air Blast
Push Punch
Side Sweep
Bi-Dir Paddle
End Flap
Drop Nose
Retracting Band
Stroke, in.

Reject Bin:
YesNo
Locking
S.Stl.
Plastic

Product Guides:
None
Fixed
Adjustable

Location:
Infeed
Thru Aperture
Full Length
Required Height:
Describe Current Methods or Problems: