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Page 1 of 3 45 Eisenhower Drive, Suite 350 Paramus, NJ 07652 Tel: (201) 267-8670 Fax: (201) 368-8989 www.modularprocess.com MODULAR PROCESS SYSTEMS | DISTILLATION | LIQUID EXTRACTION | ENGINEERING | PILOT TESTING INQUIRY QUESTIONNAIRE Please fax to 201-368-8989 or email to [email protected] Inquiry Date:__________________ CUSTOMER INFORMATION Customer Name: __________________________________ Title: ____________________________________ Company Name: ___________________________________________________________________________ Mailing Address:____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Email Address: _____________________________________________________________________________ Telephone Number: __________________________________ Fax: __________________________________ Type of Business: ___________________________________________________________________________ Is Secrecy Agreement Required? ___________________________________________________ Type of Proposal Required: ___________________________________________________ Date Proposal Required: ____________________________ Notes or Comments: ________________________________________________________________________ _________________________________________________________________________________________ PROCESS INFORMATION General Process Objective: ___________________________________________________________________ __________________________________________________________________________________________ Feed Flowrate [ ]:______________________________________________________________________ Feed Composition - Specify Weight Percents or Flowrates of ALL Components: __________________________________________________________________________________________ __________________________________________________________________________________________ Feed Temperature [ ]: ___________________ Does Feed Contain Solids? Explain:_____________________________________________________ Is the Feed Corrosive? Feed pH:____________Explain: _________________________________ Does Feed Contain Chlorides? PPM:____________Explain:_________________________________ Distillate Composition Desired - Specify Weight % or Flowrates of KEY Components:____________________ __________________________________________________________________________________________ Distillate Temperature [ ]:_____________________________ Bottoms Composition Desired - Specify Weight % or Flowrates of KEY Components: __________________________________________________________________________________________ Bottoms Temperature[ ]:_____________________________ Other Product(s) - Specify Weight Percents or Flowrates of KEY Components:__________________________ __________________________________________________________________________________________

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45 Eisenhower Drive, Suite 350 Paramus, NJ 07652 Tel: (201) 267-8670 Fax: (201) 368-8989 www.modularprocess.com

MODULAR PROCESS SYSTEMS | DISTILLATION | LIQUID EXTRACTION | ENGINEERING | PILOT TESTING

INQUIRY QUESTIONNAIRE Please fax to 201-368-8989 or email to [email protected]

Inquiry Date:__________________

CUSTOMER INFORMATION

Customer Name: __________________________________ Title: ____________________________________

Company Name: ___________________________________________________________________________

Mailing Address:____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

Email Address: _____________________________________________________________________________

Telephone Number: __________________________________ Fax: __________________________________

Type of Business: ___________________________________________________________________________

Is Secrecy Agreement Required? ___________________________________________________

Type of Proposal Required: ___________________________________________________

Date Proposal Required: ____________________________

Notes or Comments: ________________________________________________________________________

_________________________________________________________________________________________

PROCESS INFORMATION

General Process Objective: ___________________________________________________________________

__________________________________________________________________________________________

Feed Flowrate [ ]:______________________________________________________________________

Feed Composition - Specify Weight Percents or Flowrates of ALL Components:

__________________________________________________________________________________________

__________________________________________________________________________________________

Feed Temperature [ ]: ___________________

Does Feed Contain Solids? Explain:_____________________________________________________

Is the Feed Corrosive? Feed pH:____________Explain: _________________________________

Does Feed Contain Chlorides? PPM:____________Explain:_________________________________

Distillate Composition Desired - Specify Weight % or Flowrates of KEY Components:____________________

__________________________________________________________________________________________

Distillate Temperature [ ]:_____________________________

Bottoms Composition Desired - Specify Weight % or Flowrates of KEY Components:

__________________________________________________________________________________________

Bottoms Temperature[ ]:_____________________________

Other Product(s) - Specify Weight Percents or Flowrates of KEY Components:__________________________

__________________________________________________________________________________________

Page 2 of 3

45 Eisenhower Drive, Suite 350 Paramus, NJ 07652 Tel: (201) 267-8670 Fax: (201) 368-8989 www.modularprocess.com

MODULAR PROCESS SYSTEMS | DISTILLATION | LIQUID EXTRACTION | ENGINEERING | PILOT TESTING

UTILITIES AVAILABLE

High Pressure Steam [ ]: __________________ Low Pressure Steam [ ]:______________________

Hot Oil Type:________________________________ Supply Temperature [ ]:______________________

Max. Capacity of Hot Oil System [ ]:_______________________________________________________

Max. Cooling Water Supply Temp [ ]: ___________Return Temp [ ]:__________________________

Is There a Limit on Availability of Cooling Water? [ ]:_________________________________

Chilled Water Supply Temp [ ]: ________________Return Temp [ ]:__________________________

Type of Coolant Used for Chilled Refrigerant:_____________________________________________________

Other Temperature Level of Chilled Water or Coolant:______________________________________________

Max. Capacity of Refrigeration System [ ]:_________________________________________________

Instrument Air Supply Pressure [ ]:_______________Nitrogen Pressure [ ]:____________________

Electrical Power Available: [Volts]_______________ [Phase]__________________[Hz]___________________

INSTRUMENTATION

Type of Control System Desired:

Control System Manufacturer:__________________________________________________________________

Who Will Supply Control System?______________________________________________________________

Customer Preferences for Field Instrument Manufacturers:

Transmitters: __________________________Control Valves:_________________________________

Pressure Gauge:________________________Thermometers:__________________________________

Relief Valves:__________________________Other Instruments:______________________________

Electronic Instrument Type (HART, DE, Fieldbus, etc):_____________________________________________

Page 3 of 3

45 Eisenhower Drive, Suite 350 Paramus, NJ 07652 Tel: (201) 267-8670 Fax: (201) 368-8989 www.modularprocess.com

MODULAR PROCESS SYSTEMS | DISTILLATION | LIQUID EXTRACTION | ENGINEERING | PILOT TESTING

GENERAL INFORMATION

Materials of Construction: Process Equipment:____________Process Lines:___________Utility Lines:_______

Whose Piping Specifications Will be Used? ____________________________________

Type of Structural Steel: _______________________________________

Whose Painting Specification Will be Used? _______________________________________

Who Will Supply Heat Tracing? Heat Tracing Type?_____________________________

Who Will Supply Insulation? Insulation Type:___________________________________________

Who Will Supply Lighting? Lighting Type:_____________________________________________

Will Fireproofing be Applied to Structural Steel? _________________________________________

Maximum Plot Size:_____________________________Maximum Height:______________________________

Area Electrical Classification and Division:_______________________________________________________

Where Will Unit be Installed? ________________________________________________

Design Windload [ ]:_________________________ Seismic Zone:________________________________

Module Access:

Ladders Stairs

Other:________________Explain:______________________________________________________