The following Solvent Usage Data Sheet (SUDS) will allow us to evaluate your recycling needs and recommend a solvent recovery system that will meet your performance expectations and save you the greatest amount of money. Print the form out, complete it, and return it via fax to: Black Rhino Recycling (412) 460-0166. If you have any questions, give us a call at (412) 460-0160 or send email to arhino@nauticom.net
DATE: ____________________________ TIME: ___________________________
CONTACT NAME _______________________________________________________
TITLE ______________________________________________________________
TELEPHONE # ________________________________________________________
TELEFAX # __________________________________________________________
COMPANY NAME _______________________________________________________
TYPE OF BUSINESS ___________________________________________________
STREET ADDRESS _____________________________________________________
CITY, STATE, ZIP CODE ______________________________________________
SOLVENTS USED 1) _____________________ 2)________________________
COST PER GAL. 1) _____________________ 2)________________________
CONTAMINANT 1) _____________________ 2)________________________
EST. % SOLVENT 1) _____________________ 2)________________________
WATER IN WASTE 1) _____________________ 2)________________________
ACCEPTABLE % H20
IN RECOVERED
SOLVENT 1) _____________________ 2)________________________
DISPOSAL COST
PER GALLON 1) _____________________ 2)________________________
MONTHLY WASTE
VOLUME IN GAL. 1) _____________________ 2)________________________
WASTE ON HAND 1) _____________________ 2)________________________
HOW IS THE SOLVENT USED AND HOW DOES IT GET CONTAMINATED:
____________________________________________________________________
WHAT ARE THE WASTE SOLVENT COLLECTION AND STORAGE PROCEDURES:
____________________________________________________________________
WHAT IS THE INTENDED USE FOR THE RECLAIMED SOLVENT:
____________________________________________________________________
WHAT ARE THE SPECIFIC GOALS YOU HOPE TO ACCOMPLISH BY RECYCLING:
____________________________________________________________________
CIRCLE DEGREE OF NEED: IMMEDIATE NEXT QUARTER SHOPPING