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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: