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Plant Survey Form
On-Line
Company Name: *required field
Plant Number / Name:
Plant Address:
City, State, Zip:
Contact: *required field
Phone / Cell Number: *required field
E-mail Address: *required field
Submitted By: *dealers only

Additional Contact Info:

Plant Section
Plant Manufacturer:
Plant Model:
Direct Wired or Amphenol Quick Connect:
Hood Control:
Boot Control:
Do You Need to Order a Printer:
Would You Like Remote Batch on This Plant:
Current Batch Control System:

Notes:

Aggregate Section
Number of Aggregate Bins: Number of Aggregate Materials:
Aggregate Scale Capacity (lbs.): Load Cells Installed:
Scale Indicators: If "Yes" Make & Model of Indicator:
Aggregate Discharge Type: If "Special" Please Describe:
Do you have a Moisture Probe: If "Yes" Make & Model of Probe:
Do You Need to Order a Moisture Probe: If "Yes" How Many:

Notes:

Cement Section
Number of Silos: Number of Cement Materials:
Cement Scale Capacity (lbs.): Load Cells Installed:
Scale Indicators: If "Yes" Make & Model of Indicator:
Cement Discharge Type: If "Special" Please Describe:
Is There a Recirculating Scale Screw: Cement Scale Aeration:
Cement Shakers: If "Yes" How Many:
Shaker Type: Cement High Indicators:
Cement Low Indicators: Dust Collector:

Notes:

Water Section
Number of Waters: Water Feed Type:
If "Metered" Water Meter Type: Does Meter Supply 110V Output Signal:
Water Pump: If "Yes" How Many:
If "Weighed" Water Scale Capacity (lbs.): Scale Indicators:
If "Yes" Make & Model of Indicator: Water Valve Type (Solenoid):
Water Tank Empty Limit: Water Scale/Tank Closed Indicator:

Notes:

Admixture Section
Number of Admixtures:  
Admix 1 Name and Type:
Admix 2 Name and Type:
Admix 3 Name and Type:
Admix 4 Name and Type:
Admix 5 Name and Type:
Admix 6 Name and Type:
Admix 7 Name and Type:
Admix 8 Name and Type:
Admix 9 Name and Type:
Admix 10 Name and Type:
Admix 11 Name and Type:
Admix 12 Name and Type:

Notes:

Mixer Section
Mixer Type: Mixer Hydraulics:
Mixer Tilt and Right Limits (if tilt mixer): Slump Meter:
Mixer Closed Limit (if pan mixer): Temper Feed:
Erie Mixer 10% Limit Controls:    

Notes:

 

Additional Plant Notes, Comments or Recommendations


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