APPLICATION INFORMATION FORM
                                                                                                                                                                                                                               Made for 
                  Extractive Solutions                                                                                                                                                                MD065_01
                                                                                                                                                                                                                                 Process
                  APPLICANT INFORMATION                                                                                                                END USER INFORMATION
                       Company Name                                                                                                                         Company Name
                                      Address                                                                                                                               Address
                                               City                                                                                                                                 City
                                  State, ZIP                                                                                                                            State, ZIP
                       Contact Person                                                                                                                        Contact Person
                                          Phone                                                                                                                                 Phone
                                         Mobile                                                                                                                                Mobile
                                            email                                                                                                                                email
                                  Reference                                                                                                                            Reference 
                                       number                                                                                                                                number
                  TYPE OF PLANT / PROCESS
                  STREAM COMPOSITION
                  (include all components to a 100% total. If sum < 100%, N2 is assumed as complement to 100%
                              Gas                     Formula                      Unit              Measure this?                           Range                        Minimum                          Average                       Maximum
                                                                                                            YES/NO                                                            Conc.                           Conc.                          Conc.
                  SAMPLING POINT CONDITIONS
                                                   Sample Pressure Return Pressure  Sample Gas  Dew Point                                                                                                        Particulate
                                                                                                                 1
                                                              (barg)                             (barg)  [ ]                       Temp. (°C)                         (°C)                 (mg/m3)                                   Type
                       Maximum                                                                                                                                                                                                         ….
                        Minimum                                                                                                                                                                                             Size (micron)
                       Operative                                                                                                                                                                                                       ….
                  Corrosive Components:                                              No                                         Yes. Which:
                  Solvents:                                                          No                                         Yes. Which:
                  [1]   Sample return is alwasy suggested to atmoshere to avoid pressure compensations
                  APPLICATION INFORMATION FORM
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                  APPLICATION INFORMATION FORM
                  Extractive Solutions                                                                                                                                                                                         Made for 
                                                                                                                                                                                                                                 Process
                  SITE INFORMATION
                  Sample Point
                        Sample Point Location
                        Sample Point Area Classification
                        Sample Point Ambient Temperature (°C)                                                              Max.                                               Min.                                        Average
                  Sample Line
                        Sample Line Location
                        Sample Line Ambient Temperature (°C)                                                               Max.                                               Min.                                        Average
                  Analyser / System
                        Analyser / System Location
                        Analyser / System Area Classification
                        Analyser / System Ambient Temperature                                                              Max.                                               Min.                                        Average
                        (°C)
                  Distance from Sample Point to Analyser 
                  Location:
                  Space Limitation at Analyser Location (if any):
                  UTILITIES
                        Compressed Air [2]                                                  Nitrogen (N2)                                                  Cooling Water                                                           Steam
                           Yes                              No                             Yes                             No                             Yes                              No                             Yes                             No
                  Specify Parameters (flow rate, pressure, dp, 
                  temp.)
                  Availbale Power Supply:                                                                                        V                                              Hz.                                           Phase
                  [2]   For most use, the compressed air should be at least -30°C dew point; pressure > 5 bar; 
                        oil free
                  ANALYSER / SYSTEM OUTPUTS
                             Signal Output                                           Alarms on Gas conc.                                                    Serial Output                                                Autocalibration
                          4-20 mA                        Other                             Yes                             No                                           …                                                 Yes                             No
                          Low Flow Alarm                                                     Liquid Alarm                                          High/Low Temp. Alarm                                                             Other
                           Yes                              No                             Yes                             No                             Yes                              No                             Yes                             No
                  List Special Requirements:
                  ANY OTHER RELEVANT INFORMATION - EVENTUAL ISSUES WITH THE ACTUAL MEASURING METHOD
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