TANK REQUEST FOR QUOTE Date: Contact Name: E-mail: Company Name: Phone: Street: Fax: City: State: Choose One Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusettes Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip: Tank Style(s): Vertical ___Horizontal ___IBC Tank Size(s) (gallons): Tank Diameter(s): (if critical): Tank Height(s) (if critical): Tank Construction: Choose One PE FRP Carbon Steel Other If Other: Indoor Use __Outdoor Use Chemical Service(s): Pressure: Atmospheric Only __ Other: Temperature: Ambient Only ___Other: Nozzles (Flanged): IMFO Nozzle: Yes ___No ___ If Yes, IMFO Tank Pad: Yes ___ No Nozzles (Threaded): Vent Style and Size: With Screen: Yes ___No Note: Unrestricted vent size must exceed size of tank's largest fitting by one inch; weighted hinged manway lid required if tank is filled pneumatically Wind Restraint System: No ___ Yes - Zone: MPH: Delivery Zip Code: Requested Ship Date: Notes / Comments: (936) 258-6754