Detailed Evaluation Form or email info@orioncoat.com


1. Company/Contact Information

Name:*
Title/Position:*
Company:*
Phone:*
Ext:
Fax:
E-mail:*
Address:
City:*
State:
Zip:
Web Url:
How did you hear about Orion?
How would you prefer to be contacted:
Please describe the nature of your request:*

2. Part and Operating Environment Data

Name/Number of Part:
Substrate Material
Brieft Description of part and end use:
Present plating or coating:
What Needs to be improved with your present coating or service?:
Describe operating conditions and environment: (surface speed, temp., pressure, abrasives, chemicals, etc.)

3. What do you expect the Orion-applied coating to accomplish, resist or improve?

Rank the importance of the following characteristics of the applied coating.
NA:Not Applicable / 1: least needed /6: most needed
Non-Stick Release Easy Clean
N/A 1 2 3 4 5 6
Friction: Low High
N/A 1 2 3 4 5 6
Resistance: Abrasion Wear
N/A 1 2 3 4 5 6
Resistance: Chemical Corrosion
N/A 1 2 3 4 5 6
Electrical: Insulation Conductivity
N/A 1 2 3 4 5 6
Noise Reduction:
N/A 1 2 3 4 5 6

FDA Medical Other
If Other Please Specify:
Max Operating Temperature(in degrees Fahrenheit):
Minimum Operating Temperature (in degrees Fahrenheit):
Describe quality control procedure(s) used:
Describe quality control procedure(s) sued:

4. Production Data

Yearly Production:
Lot Size(s):
Turnaround Time Required:
TimeLine Now 0-30 31-90 91-120+days

5. Specify dimensions in the area below:

6. Special Assembly, Testing, Packaging or Shipping Requirements:

7. Other info

Please identify any colleagues
or affilates who may require our services: