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http://www.aaamachine.com fujisaki-e700@aaamachine.com
Tel: +1-847-886-4535, skype: carlishito
Engineering Data Sheet (EDS) -Confidential

Tel : +1-800-996-0070 Fax : +1-847-376-3530

APPLICATION FOR EXPERIMENT- Fujisaki Micro-Mist-Spray-Dryer -■APPLICANT■
Name of Company
Address
Person in Charge

Title / Division

Phone Number

Facsimile Number

E-Mail Address
Payment Term
Presence at the Test

Yes / No

Preferred Date of Test

Dedicated Collection Filter

Yes / NoOthers■TEST-SAMPLE■ (Please include MSDS along with this form)

Chemical Name (Formula)
Method of Storage

Ordinary Temperature / Refrigeration

Physical Change -Overtime
Characteristics

Solution / Suspension (Primary Average Particle-Size:

Solvent

Water / Others (Name of Solvent:

Solid Content Consistency

wt%

Viscosity

CPμm ))

Solution Specific Gravity

g/cc

pH

Hygroscopic Property

Yes / No

Deliquescence

Yes / No

ExplosivenessYes / No

Heat-Sensitivity

Yes / No

Toxicity

Yes / No

Corrosiveness against SUS

Yes / NoSpecific-Heatkcal/kg℃

OthersYour Comment, if any■TEST-TARGET■

Desired Particle-Size
Moisture-Content in Dry-Powder
Required Amount in Dry-Powder
Any Other Requirements■OTHERS■

Temperature Limitation
Cleaning Procedure
Disposal Procedure
Sample Handling Cautions
Test with Other Dryers

Yes/No (If yes, please describe the below Condition and Reason why not meet your need.)

Inlet-Temperature

Outlet-Temperature

Capacity

Spray-Nozzle Type

Reason why not meet target
I hereby grant this Sample-Material is safe to human body and will not harm Operator(s) of the Test-Equipment.
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Signature

Date

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1. Purpose[(Please check)] Preliminary equipment evaluation,[] Product evaluation,[] Contract manufacturing

2. Requirements :2.1 End product should be :[] No particle size specification[2.2 Desired particle size distribution of the end product :[] abovemicrons,%[] below

microns,%] Particle size specification to be achieved[ ] control sample shipped with feedcomments :2.3 Feed rate (kg/hr) :2.4 Estimated production rate of end product (kg/hr) :2.5 Please specify which of the following requirements is most important :[] to get strict particle diameter rather than yield[] to get certain yield rather than strict particle diameter[] other

2.6 Minimum amount of target sample required for customer’s evaluation :2.7 Rest of tested and non-tested material should be :[] Shipped back (collect) Carrier:[] Shipped back (prepaid if you do not have a carrier account), [Account No.:] Other* The remained material may not be disposed of by AAAmachine because of environmental regulation.
3. Particle Characterization at AAAmachine laboratory (1291 Rand Rd., Des Plaines, IL 60016)
3.1 The following measuring apparatus are available.
[] Coulter counter Multisizer II

Please check if PSD measuring is needed.

Aperture :microns

3.2 The following measuring apparatus are available using outsource service. Pleasecheck if this service is needed.
[] laser type (wet) [] laser type (dry)[] other

3.3 Dispersion condition :[] Liquid and/or Media :[] Wet reagent :[] Ultrasonic wave bath (sec./min.) :[] Other :4. The method how to evaluate the products on site:
5. Please specify possible or impossible material (in the machine) to be contacted (if you need):[] possible[ ] impossible

6. Please specify contamination allowance (if required) :7. Desired Test Date:
8. Attendance of test:/[/201] No, [ ] Yes (Customer)(Agent)CONFIDENTIALITY
AAAmachine will hold in confidence the identification of your sample, and confidentially marked specifications from you, the date wegenerate, and the results we provide to you. AAAmachine dispose all excess sample material, unless make specific provision for its return.

MATERIAL SAFETY DATA SHEETS (MSDS) ARE REQUIRED BEFORE SAMPLES CAN BE PROCESSED.