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    HEADWORKS INC
    MECHANICAL SCREEN INQUIRY SHEET

    To request a quote, please complete this form with all relevant information and submit via phone, fax, or
    email to the attention of Headworks Screen Quotes:

    TELEPHONE+1.713.647.6667

    FAX+1.713.647.0999

    EMAILquotes@headworksintl.com

    Project Name (if available):

    Category (check one)

    MunicipalIndustrial

    Company Name:

    City & State

    Country:

    Contact Person:

    Tel:

    Fax:

    Email:


    MS Bar ScreenPerforatorEliminatorSpiralman

    Measurement Units (check one):

    ImperialMetric

    Number of screens required:

    Channel Depth:

    Channel Width:

    Discharge Level :

    Water depth:

    Maximum flow per screen:

    expressed in (check one):

    L/SMGDGPM

    Screen opening size

    *:

    Material of fabrication (check one)

    SS 304SS 316

    Explain special circumstances (example: heavy debris in your channel)

    Conveying Equipment

    *:

    YesNo

    Compacting Equipment

    *

    YesNo

    Washing system

    *

    YesNo

    Length

    Any other information we should know in order to prepare this proposal: