®

COMPANY INFORMATION
Contact Person Name
Company Name & Address
Contact No		O  M
Email
PRODUCT  INFORMATION
Type
Dimension
Metallurgy
Finish		Painted     Chrome Painted
		Anodized Galvanised Other
PACKAGING  INFORMATION (Existing)
Type                Primary
Secondary
Single
Dimension
Air Proof		Yes    No
Water Proof		Yes     No
Volume of Package
CORROSION  PROTECTION  SYSTEM
Current Corrosion Prevention		Yes    No
Current Type of System
Wherether Satisfied With Current System		Yes    No
Current Corrosion Problem
Protection Duration		6 12 18 24 60 120 months