Skip to content
HOME
ABOUT US
PRODUCT
CLIENTS
CONTACT
ASSESSMENT QUESTIONNAIRE
CLIENT ACCESS
HOME
ABOUT US
PRODUCT
CLIENTS
CONTACT
ASSESSMENT QUESTIONNAIRE
CLIENT ACCESS
Technical Assessment Questionnaire
Technical Assessment Questionnaire
Rustech
2020-07-12T16:46:14-04:00
Contact Information
Name of person responsible for this information
*
(First, Last)
Title
*
Company
*
Type of business
*
Email
*
Date
*
MM slash DD slash YYYY
Contact number
*
Were you referred by anyone?
*
Select option
Yes
No
If yes, please specify.
Please specify
*
Specifications of Project
Is the project in the development stage?
*
Select option
Yes
No
Manufacture name of the equipment
*
Type of metal
*
Dimensions of equipment or structure (HxLxW)
*
Weight of equipment or structure
*
In pounds
In metric tons
Level of corrosion of equipment or structure
*
Select option
Initial
Intermediary
Advanced
Location of equipment or structure
*
Select option
Open place
Closed environment
Is there a power source near the equipment or structure?
*
Select option
Yes
No
Power source
*
120/240 V
360 V
Type of environment
*
Select option
Humid
High temperatures
Sea air
Other (please specify)
Please specify
*
Chemical product?
*
Select option
Yes
No
What kind?
*
Are there vanishing points or indentations on the metal of the equipment or structure?
*
Select option
Yes
No
Unsure
Is the maintenance cost of the equipment/structure known?
*
Select option
Yes
No
How much in USD per month?
*
How much in USD per year?
*
Are there any photos available of the equipment or structure that can be shared with Rustech?
*
Select option
Yes
No
Attach below
Drop files here or
Select files
Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 20 MB.
Allowed file extensions: jpg, jpeg, gif, png, pdf
Rustech Representative Information (if applicable)
Name (First, Last)
Title
Contact Number
Email
Region
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.
Page load link
Go to Top
