If you have a specific cleaning related problem, please fill out the form below so we can direct your questions to the appropriate applications specialist:
Items in red are required.
1. Consultation Code (if applicable):
2. Contact information:
Name:
Title:
Company:
Address 1:
Address 2:
City:
Region/Province/State:
Postal Code/Zip Code:
Country:
Phone:
Fax:
E-mail:
Web:
3. Your principal activity:
Healthcare
Laboratory
Environmental & Water Testing
Electronics
Pharmaceutical
Food & Dairy
Cosmetics
Metalworking
Optical
Nuclear
Educational Institution
Medical Device Manufacturing
Precision Manufacturing (please describe):
Other (please describe):
4. What size/how often do you purchase high-quality cleaners?
units (single boxes or bottles) - weekly
monthly
yearly
cases (cases of boxes or bottles) - weekly
monthly
yearly
med. Sizes (50-100 lb or 5-15 gal drum) - weekly
monthly
yearly
bulk sizes (300 lb or 55 gal drum) - weekly
monthly
yearly
5. Your primary job function:
Administrative Assistant
Consultant
Corporate Management
Engineer
Healthcare
Laboratory Manager
Plant Manager
Purchasing
QC/QA Validation
Safety/Regulatory Compliance
Sales/Marketing/Distribution
Scientist/Researcher/Teacher
Stockroom/Store/Warehouse
Technician
Other (please describe):
6. Estimated annual purchases of high-quality cleaners in US$ (if known):
7. What surfaces are you cleaning?
Polycarbonate, acrylic, and other sensitive plastics
Filters, membranes, RO or UF systems
PC boards, wafers, electronic components
Pipets in syphon washers
Soft metals: aluminum, copper, brass, other non-ferrous
