Guided Wave Application Questionnaire Form


Please fill out this form to let us know about your application.
(* required fields).

No time at the moment? Just give us your name and number on our short form and we will get back to you promptly.


Personal Information


Name:
*
Mr. Ms. Dr.
Title:
Company Name:
*
Address:
City:
*
State /Province/ Territory:
Country:
*
Zip:
Phone:
*
Include Area Code and where applicable, the Country Code.
Fax:

Include Area Code and where applicable, the Country Code.
Email:
*

Analysis Detail (Liquids or Gases Only)

What type of analysis is desired?
In-line        At-line
Laboratory Laboratory first, then process
Product to be analyzed?
Current analytical method?
Why change?
If current method is spectroscopy,
UV VIS NIR Other
Wavelengths/ Wavenumber:
to
Normal sample physical state?
Gas Liquid Slurry Paste Film
Other
Measurement frequency?
The current method is:
Qualitative Quantitative
Sample Conditions Temp:
Min °   Typl °   Max °
Pressure :
Min     Typ    Max   
Viscosity:
pH:

Sample Interface

Direct insertion of fiber optic probe into the process
(reactor, large tank, large pipe)
If direct insertion, do you need a means to retract the probe for cleaning due to temperature or pressure
Flow cell for <2” diameter slip stream
Unsure

Sample Chemistry

List the parameters or properties below that you are interested in monitoring:
Constituent Concentration Range Current Method Precision
1.
2.
3.
4.
5.
6.
7.
8.
Other significant chemical components or characteristics.
List and/or describe.:
Are you interested in shipping us samples for a study?
Yes No
IF YOU SEND SAMPLES YOU MUST SEND THE APPLICABLE MSDS's !

Purchase Decision

When does your company expect to make a purchase?
Immediately 1-3 months 4-6 months
Within the year In more than one year.
Unknown
Project budgeted?
Yes No
Who else will be involved in any purchase decision?
Lab Manager Process supervisor Plant manager Other

Basis for Purchase (1 least important; 5 most important)

Continuous Results
1 2 3 4 5
Save Analytical
Time/ Cost
1 2 3 4 5
Improved Safety
1 2 3 4 5
Catch Upsets
1 2 3 4 5
Product quality
1 2 3 4 5
Other Comments:


 

Corporate Headquarters:

Guided Wave Inc.

3033 Gold Canal Drive
Rancho Cordova, CA 95670
USA
Tel: 916 638-4944
Fax: 916 635-8458

.
© 2006 Guided Wave, Inc.
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