PRODUCT INFORMATION - For Bag Fillers
	#1	#2	#3	#4
Name of Product or (ID Code)
Fill Weight
Speed Per Minute
Desired Accuracy
Bulk Density (loose)
Bulk Density (settled)
Particle Size
Product Fed to Us:
	Gravity	Gravity	Gravity	Gravity
	Airveyed	Airveyed	Airveyed	Airveyed
	Screw	Screw	Screw	Screw
	Belt	Belt	Belt	Belt
	Hand	Hand	Hand	Hand
	Other	Other	Other	Other
	From Where	From Where	From Where	From Where
Characteristics - Please Check All That Apply
	Free_Flowing Small Granular (salt, sugar, etc.)	Free_Flowing Small Granular (salt, sugar, etc.)	Free_Flowing Small Granular (salt, sugar, etc.)	Free_Flowing Small Granular (salt, sugar, etc.)
	Toxic	Toxic	Toxic	Toxic
	Non Free_Flowing Powder	Non Free_Flowing Powder	Non Free_Flowing Powder	Non Free_Flowing Powder
	Poisonous	Poisonous	Poisonous	Poisonous
	Free_Flowing Large Granular (beans, nuts, rice, etc.)	Free_Flowing Large Granular (beans, nuts, rice, etc.)	Free_Flowing Large Granular (beans, nuts, rice, etc.)	Free_Flowing Large Granular (beans, nuts, rice, etc.)
	Explosive	Explosive	Explosive	Explosive
	Non Free_Flowing Granular (brown sugar)	Non Free_Flowing Granular (brown sugar)	Non Free_Flowing Granular (brown sugar)	Non Free_Flowing Granular (brown sugar)
	Corrosive	Corrosive	Corrosive	Corrosive
	Free_Flowing Powder	Free_Flowing Powder	Free_Flowing Powder	Free_Flowing Powder
	Abrasive	Abrasive	Abrasive	Abrasive
	Hydroscopic	Hydroscopic	Hydroscopic	Hydroscopic
	Dusty	Dusty	Dusty	Dusty
	Free Flowing	Free Flowing	Free Flowing	Free Flowing
	Sluggish	Sluggish	Sluggish	Sluggish
	Inflammable	Inflammable	Inflammable	Inflammable
	Flushes	Flushes	Flushes	Flushes

Does bulk density change (on the same product) due to different batches, time of day, moisture level, etc.?
Yes, explain		No

Percentage of Moisture in Product
Temperature of Product When Being Packaged
Additional notes on the product. Please include any specific characteristics regarding the products flowability, ease of handling, past problems with filling, etc.

PACKAGE (BAG) INFORMATION- For Bag Handlers and Bag Sealers
	Bag #1	#2	#3	#4
Bag Style - (closure type)
	PinchSOMWicketedPillowGussettValveStand-UpSewnTwist-TieGlue FoldHeader CardOther	PinchSOMWicketedPillowGussettValveStand-UpSewnTwist-TieGlue FoldHeader CardOther	PinchSOMWicketedPillowGussettValveStand-UpSewnTwist-TieGlue FoldHeader CardOther	PinchSOMWicketedPillowGussettValveStand-UpSewnTwist-TieGlue FoldHeader CardOther
Bag Type (Paper, Polyethelyne, Polypropylene, Cello, Laminent, Foil, Tyvek...)
Bag Thickness
Bag Weight (lb./kg.)
Empty Bag Size (LxWxH)
Filled Bag Size
Desired Speed (Bags Per Minute)
Modified Atmosphere (Gas Flush)?
	Yes	No	Sometimes
Is Vacuum Needed?
	Yes	No	Sometimes
Is Seal Testing Required?
	Yes, what specifications?	No
Is Validation Required (Medical)?
	Yes	No	Sometimes
Is Coding Onto Bag Required?
	Yes, what is code?	No
Where Will Sealer Be Located?
	Floor (stand required)	Table	Other
Does it make sense to have multiple machines to achieve the desired output? - Possibly because of different areas needing sealers, multiple fill points, etc.
	Yes, how many?	No	Maybe

THIS SECTION FOR Valve bags only
Name
Valve Size
Valve Type	Stepped-in    (internal) Tuck-in    (external) Heat Seal	Stepped-in    (internal) Tuck-in    (external) Heat Seal	Stepped-in    (internal) Tuck-in    (external) Heat Seal	Stepped-in    (internal) Tuck-in    (external) Heat Seal
Additional notes on package (bag) information - Please include any additional information that will help us understand your package. Inclued attributes such as sealability, past problems you have experienced, new materials that may be used in the future, etc.

Pack Off Questions
Type of Pack-Off Desired		Circular Table		Conveyor with    Table
If Circular Table:
Diameter of Table Top	36"	48"	60"	Other
Table Top Design	Lip, height    of lip		Flat Top
Construction of Table	Stainless    Steel	Mild    Steel    Painted	Other
Speed	Revolutions    per minute    (If known)	Fixed    Speed		Variable    Speed
Motor Preference, if any
Please include any additional information (or requests) that pertain to the circular table you are requesting:

If Conveyor with Table:
Overall Conveyor Length
Overall Conveyor Width
Overall Conveyor Height
Size of Shelves
Construction Type		Stainless    Steel	Mild Steel -    Painted	Other
Motor Preference, if any
Conveyor Speed
Elevation
Room Environment	Wet	Dry	Dusty	Other
Please describe the system you envision working best for your operation. Please include as much detail as possible, including description, environment, etc.

Feed Conveyor Questions
Type of Conveyor	Incline (Increased height at angle)	Bucket		Other
Product to be conveyed
Infeed Elevation	Floor level 36"			Other - Specify
Discharge Height	Into filler we are proposing			Specify Height
Length of Conveyor	Determined by ZiggyPak			Specify
Width of Conveyor	Determined by ZiggyPak			Specify
Capacity	Number of Lbs. Per Hour
Is there a belting/chain preference?	Intralox	Rexnord	No preference-use standard	Other - Specify
Type of Construction	Stainless Steel	Mild Steel-painted		Other - Specify
Type of supports required	Floor Supports (on floor)	Ceiling Supported	No Supports Needed	Other - Specify
Motor/Gearbox preferences	Use Standard			Other-Specify
Please include any information that will help us understand what exactly is required for your conveyor. Most of these are custom built for the application so please include all specs you would like. Also, please include particular things that you know will definitely not work.