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http://www.aaamachine.com aaamachine@aaamachine.com
Tel: +1-847-481-8264, skype: carlishito
AAAmachine, Inc. 1291 Rand Road, Des Plaines, IL 60016 USA
Engineering Data Sheet (EDS) -Confidential Tel : +1-800-996-0070 Fax : +1-847-376-3530
Company :Address :City :
Telephone :Department :State :

Submitted by :Zip code :Fax :Country :Title :

Date :

1. Material (Please include MSDS along with this form)
1.1 Trade Name :1.2 Chemical Name :1.3 Amount of Material supplied :1.4 Container type :1.5 Sample delivery date :1.6 Delivery method :2. Purpose (Please check)
2.1 [ ] Preliminary equipment evaluation
2.2 [ ] Product evaluation
2.3 [ ] Contract manufacturing
3. Process Requested (please check)
3.1 [ ] Surface treatment (embedding, Filming, spheronizing, composition, etc.)
3.2 [ ] Spray drying
3.3 [ ] Dust removing
3.4 [ ] Air classification only
3.5 [ ] Grinding only
3.6 [ ] Grinding and classification[ ] closed circuit system [ ] open circuit system
3.7 [ ] Other
4. Feed Material Characteristics
4.1 Maximum particle size (microns) :4.2 Medium particle size (microns) :by (measuring method) :4.3 Bulk density (loose) (g/cm3) :4.4 Specific gravity :4.5 Please check all those which applies[ ] abrasive[ ] poisonous[ ] explosive[ ] electrostatic[ ] other[ ] cohesive, adhesive[ ] hygroscopic[ ] conductive[ ] flushing

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5. Requirements :comments :[ ] control/target sample shipped with feed

5.1 End product should be (if related with particle size, such as air classification):[ ] Fine fraction[ ] Coarse fraction[ ] Middle fraction
5.2 Desired particle size distribution of the end product (if required):[ ] abovemicrons,%[ ] belowmicrons,%
5.3 Feed rate (kg/hr) :5.4 Estimated production rate of end product (kg/hr) :5.5 Please specify which of the following requirements is most important :[ ] to get strict particle characteristics rather than yield[ ] to get certain yield rather than strict particle characteristics[ ] other
5.6 Minimum amount of target sample required for customer’s evaluation :5.7 Rest of tested and non-tested material should be :[ ] Shipped back (collect) Carrier:Account No.:[ ] Shipped back (prepaid if you do not have a carrier account), [ ] Other* The remained material may not be disposed of by AAAmachine because of environmental regulation.
6. Particle Characterization
6.1 Please specify If you want us to use a particle characterization measuring apparatus.
[ ] Coulter counter Multisizer III
Aperture :microns[ ] Laser type (wet)[ ] Laser type (dry)[ ] SEM [ ] TEM [ ] Circularity Index measurement device[ ] Other apparatus:* Please understand we may have to use outsourcing service depending on the availability.
6.2 Dispersion condition (if needed):[ ] Liquid and/or Media :[ ] Wet reagent :[ ] Ultrasonic bath (sec./min.) :[ ] Other :7. The method how to evaluate the products on site:
8. Please specify possible or impossible material to be contacted (if needed):[ ] possible[ ] impossible
9. Please specify contamination allowance (if required) :10. Desired Test Date://20
11. Attendance of test:[ ] No, [ ] Yes (Customer)(Agent)12. Have you processed this material before? Please describe results.

CONFIDENTIALITY
AAAmachine will hold in confidence the identification of your sample, and confidentially marked specifications from you, the date we generate,
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.