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CUSTOMER INFORMATION
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*Customer Name:
Title:
Company Name:
Company Address:
City:   State:   Zip:   
Country:
*Email Address:
Telephone Number:
Fax:
Type of Business:
Is Secrecy Agreement Required? Yes No
Type of Proposal Required: Budgetary Firm
Date Proposal Required:

PROCESS INFORMATION
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General Process Objective:

Feed Flowrate [GPM]:
Feed Composition (Specify weight percents or flowrates of ALL components):

          Feed Temperature [°F]: 
Does Feed Contain Solids? Dissolved Suspended Both No   Explain:
Is the Feed Corrosive? Yes No Feed pH:
Does Feed Contain Chlorides?   Yes No PPM:
Distillate Composition (Specify weight percents or flowrates of KEY components):

          Distillate Temperature [°F]: 
Bottoms Composition (Specify weight percents or flowrates of KEY components):

          Bottoms Temperature [°F]: 
Other Product(s) (Specify weight percents or flowrates and temperatures of KEY components):

UTILITIES AVAILABLE
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High Pressure Steam [PSIG]:   Low Pressure Steam [PSIG]:
Hot Oil Type:   Supply Temperature [°F]:
Maximum Capacity of Hot Oil System [BTU/HR]:
Maximum Cooling Water Supply Temperature [°F]:   Return [°F]:
Is there a limit on Availability of Cooling Water? Yes No [GPM]
Chilled Water or Coolant Supply Temperature [°F]:   Return [°F]:
Type of Coolant Used for Chilled Refrigerant:
Other Temperature Level of Chilled Water or Coolant:
Maximum Capacity of Refrigeration System [BTU/HR]:
Electrical Power Available: [Volts]  [Phase]  [Hz]

INSTRUMENTATION
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Type of Control System Desired: DeltaV PLC DCS Other N/A
Control System Manufacturer:
Who Will Supply Control System? KMPS Customer N/A
Customer Preferences for Field Instrument Manufacturers:
          Transmitters:
          Control Valves:
          Relief Valves:
          Pressure Gauges:
          Thermometers:
Type of Field Instrumentation: Electronic Pneumatic N/A
Instrument Air Supply Pressure [PSIG]:

GENERAL INFORMATION
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Materials of Construction:
          Process Equipment:
          Process Piping:
          Utility Piping:
Whose Piping Specifications Will be Used? KMPS Customer N/A
Type of Structural Steel: Tubular - Painted I-Beam - Bolted Galvanized I-Beam - Painted Welded N/A
Whose Painting Specification Will be Used? KMPS Customer N/A
Who Will Supply Heat Tracing? KMPS Customer N/A   Heat Tracing Type? KMPS Customer N/A
Who Will Supply Insulation? KMPS Customer N/A   Who Will Supply Lighting? KMPS Customer N/A
Will Fireproofing be Applied to Structural Steel? Yes No
Maximum Plot Size:   Maximum Height:
Area Electrical Classification and Division:
Where Will Unit be Installed? Outdoors Indoors
Design Wind load [MPH]:   Seismic Zone/Code?

Other Notes or Comments:

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