Incinerator Sheet

Please print this form and fax it to us at (330) 665-1613

Name_____________________________________________________________________
Company___________________________________________________________________
Address____________________________________________________________________
City, State, Zip_______________________________________________________________
Phone______________________________________Fax ____________________________
E-mail______________________________________

22151 E. 91st St. Broken Arrow, OK 74014
Phone: (918) 258-8551 Fax: (918) 251-5519

INCINERATION SYSTEM DESIGN INFORMATION

Customer Date

Customer Ref. No. Fax No. Due Date

Customer Contacts Phone

Phone

Address for Correspondence

End User Location

Zeeco Quote No. Representative

WASTE CHARACTERISTICS: (Attach Analysis Sheet if Available)

Stream Name Rate^* Min/Max Pressure^* Temperature^*

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/

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COMPOSITION

Component Stream Name

Viscosity^*

Density^*

UTILITIES

Type of Fuel Oil Temperature Pressure

Type of Fuel Gas Temperature Pressure

Steam Temperature Pressure

Electric Volts Cycles Power

Compressed Air Rate Pressure

HEAT RECOVERY

Waste Heat Boiler: : Yes / No

If yes, Steam Pressure Temperature

EMISSIONS REGULATIONS

DRE,% UBHC^*

NOx^* SOx^*

HCl^* Cl₂^*

Particulate^* Other^*

^* SPECIFY UNITS

INCINERATION SYSTEM DESIGN INFORMATION
Customer		Date
Customer Ref. No.	Fax No.	Due Date
Customer Contacts		Phone
		Phone
Address for Correspondence

End User	Location
Zeeco Quote No.	Representative

UTILITIES
Type of Fuel Oil	Temperature	Pressure
Type of Fuel Gas	Temperature	Pressure
Steam Temperature	Pressure
Electric Volts	Cycles	Power
Compressed Air Rate	Pressure
HEAT RECOVERY
Waste Heat Boiler: : Yes / No
If yes, Steam Pressure	Temperature

EMISSIONS REGULATIONS
DRE,%	UBHC^*
NOx^*	SOx^*
HCl^*	Cl₂^*
Particulate^*	Other^*
^* SPECIFY UNITS