Information Request

	Barrel Reconditioning Industries, Inc. Information Request
Manufacturer of Container Reconditioning Systems and Equipment

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If you will take a few seconds to fill-in the blanks below you'll provide us with information needed to design your container reconditioning system.

Customer Information
Name:
Organization:
Address:
Address:
City, State, Zip:
Country:
Phone:
FAX Phone:
E-mail:

Container Information
Drums
Check all that apply:	Plastic	Open Head
	Steel	Tight Head

Size (in gallons):	20	30
	55	Other

Volume on a daily basis:

IBC's
Check all that apply	Plastic	Open Head
	Steel	Tight Head

Size (in gallons):
Bung size (in inches):
Bung Location:	Center	Offset

Volume on a daily basis:

Markets Served
Check all that apply
Petroleum			Chemical, acids, and bases
Textile			Food and Beverage
Solvents			Other:

Equipment Requirements

Complete System

Specific Equipment - Describe them:

Other Information

Do you have a water treament facility?	Yes
	No
Can you discharge non-contaminated water?	Yes
	No

If you have any other suggestions or special needs, please write your comments here: