Permaweld


An ISO 9001 - 2000 Company

Technical Information Request Form - Corrosion Control Maintenance Consultancy

*Marked fields are mandatory

Company Name *

Industry Type

Person to be contacted *

Designation

Address

City

State

Zip/Code

Country

Telephone No

Fax No

Email ID *

Web Site

Best Time to Contact

Please take sometime and provide the information below.

Flooring

Moisture Content : By moisture Meter(%):

By Polythene Sheet (water Droplet Seen : or no) :

Grade of Concrete:

Existing Flatness:

Age of substrate:

Surface Condition:

Contamination

Visible Cracks: If yes, length of cracks meter

Construction Joints: If yes, length of joints meter

Expansion joints: If yes, width of joints meter

length of joints meter

Type of Finish Require:

Smooth Top:

Anti skid:

Normal Coating Finish :

Others:

Colour:

Floor Subjected to :

Any Vehicular Movement:

Truck (<20 T)

Fork Lift

Battery Truck

Trolley

Type of Wheel

If dragging of Material:
Type of Material

Weight of Material :

If Chemical Resistance Required:

Name of Chemical :

Concentration(%) :

Temperature :

Contact Period :

Ambient Temperature During Floor Execution :

During Service Hours:

If the area would be under controlled Temperature :

Max Tem :

Min Tem :

Coving Requirement:

Skirting Requirement:

Size of Coving :

Back-up lining :

Shape

Colour

Length :

Width:

Colour of Coating on Coving

Working time available: (any time/only day/only night/others) Specify

working Days available :

Any other Requirements :

	Our Location Permaweld Pvt. Ltd., Akarsh Plaza, 227, 1st Stage, 5th Phase, Shivanagar, W.O.C.R. Bangalore - 560 044, Karnataka, INDIA. Tel: 91-080-23141510 / 23141515 E-mail: permaweld@permaweld.com permaweld@vsnl.com




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