Van London Co.
Application Questionnaire
Contact Information
Date:---------
CSR: ---------
Company Name: ___________
Contact Name:
Phone Number: -----------
E-mail Address -----------
Measurement Information
Type: pH D Conductivity D Dissolved Oxygen D Other: ________________
Measurement Range: __________ Desired Accuracy: ____________
Measurement Purpose: Monitor Only D Monitor and Control D Other: ____________
Process Conditions
Type of Process_______________________________
Process Components:
Component Normal% High% Low%
pH Range: ______ Temperature Range (°Cl° F) ______ Pressure (psig): ______
Is the process colloidal, contains sludge or precipitants? : _________________
Pg 1
Pg 2
Pg 3
Pg 4