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Metalworking Fluids Quote/Questionnaire

Ship To: 
Bill To: 
Company Name: 
Company Name: 
Address: 
Address: 
Address: 
Address: 
City, State, Zip: 
City, State, Zip: 
Phone:  (000-123-1234)
Phone:  (000-123-1234)
Attn: 
Attn: 

Type of Material Machined:
(Check "Yes" to all that apply) 

Mild Carbon Steel
Cast Iron
Stainless Steel
Tool Steel
Aluminum
Copper
Brass
Titanium
Other (Specify)


Machining Process: 
 (Check "Yes" to all that apply) 
Milling
Drilling
Turning
Form Milling
Sawing
Grinding

Will your material go through either of the following processes?
Paint
Welding           
Do you use an anti-spatter?

Volume of Usage: 
Example:  10 gallons per month, or 55 gallons every qtr.
(Pick one & complete) 

Current Fluid Product:
Brand Name
Model Name and/or Number
Fluid Type

What problems are you having with your current fluid product?
Odor
Dermatitis
Paint Adhesion
Corrosion
Foaming
Price
Delivery
Other (Specify)

Does your company have a chemical management program currently in place to monitor and maintain coolant?
                                                                         

I would like information on starting a chemical management program in my shop?
                                                                         

What are the determining factors for purchasing a coolant for your facility?

Cleanliness
Not Susceptible To Odor Or Bacteria
Rust Preventative
Improved Lubricity
Longer Sump Life
Tool Life
Price
Delivery
Local Access To Product
Other (Specify)


 

HE&M INC.,  PO Box 1148 - Pryor, OK 74362
(P) 888.729.7787, (F) 918.825.4824,
info@hemsaw.com

HEM Inc. reserves the right to change the design, price, and/or specifications at any time,
without notice and without incurring any obligations.

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