ChemX3 Assistance Application Form

Per garantirvi un servizio efficiente ed ottimizzare i tempi di intervento, vi preghiamo di compilare attentamente il modulo di Richiesta Assistenza Tecnica, con il maggior numero di informazioni possibile.

Customer Information
First Name *
Last Name *
Company Name *
Address *
City *
Country *
Zip Code *
Telephone *
Fax *
E-mail *
Distributor
Customer Name
Customer Address
End User
Activity Field
Other Activity Field
Application details
Installation mode *	In-line Submersible Hot-tap
Pipe Material
Pipe Size *
Pipe Schedule
Working Pressure *	MIN: MAX: TYP:
Working Temperature *	MIN: MAX: TYP:

Fluid composition: *
	with solid
Fluid viscosity	(centipoises)
Fluid specific gravity	(Kg/m3)
Fluid conductivity range *	(µS)
Fluid pH range *	(µS)
Flow Rate	MIN: MAX: TYP:
Instrumentation description
Sensor *
Cell constant (for Conductivity Only)
Other
Sensor location
Monitor *
Distance from sensor *	(please specify the measurement unit)
Power Supply
Message/Request

Please, enter the code you see above:

Send the forms on-line or by fax to FLS Technical Support at +39 010 96216214