EmailMe Form - SATAKE SORT TEST REQUEST FORM

Date Time

MM / DD / YYYY

Satake personnel working with you regarding this request (Choose from drop down box)

If other, please fill in name on next line.

Please put in name of "Other"

Name

First Last

Company Name

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email

Office Telephone Number

### - ### - ####

Cell Number

### - ### - ####

Machine to use for testing

TELL US ABOUT YOUR PRODUCT AND SORTING REQUIREMENTS

Describe as completely as possible your product and sorting requirements:

Product Description of sample being sent in:

Product Capacity Required

Level of Purity required

Typical Level of Contamination in Incoming Product

Description of Acceptable Product
*Please include a small ziploc bag of hand sorted accepts with your sample

Description of Rejected Product
*Please include a small ziploc bag of hand sorter rejects with your sample.
If possible separate and name each type of defect or contaminant in your product

INSTRUCTIONS AND INFORMATION ABOUT SENDING SAMPLES TO SATAKE

REFERENCE: PRODUCT FOR SORT TESTS
NOTE: If product is plastics or other product requiring MSDS sheets or Phytosanitary Certificate (for international food shipments), please send to us separately or with shipment.
If MSDS or SDS is not received with Product or ahead of the product: WE MAY NOT BE ABLE TO ACCEPT YOUR PRODUCT.

Number of pounds/kilograms being shipped

Satake recommends at least a 50 lbs. sample

Estimated Ship Date of Samples:

INSTRUCTIONS UPON COMPLETION OF SORT TEST

Please let us know how to handle your sorted product:

Upon Completion of Tests

Return Entire Sample

Return Portion of Sample

Send sort test data only

If samples are NOT to be sent back, check here to authorize Satake to destroy or dispose of samples:

OK to destroy or dispose

Note: Satake may not be allowed to destroy or dispose of certain products in which case, all samples must be returned to customer.

Shipment Method:
Will return samples
via UPS unless otherwise noted.

Regular

Expedited-Second Day

Expedited-Next Day

IF SAMPLES ARE TO BE RETURNED TO A DIFFERENT ADDRESS FROM ABOVE, PLEASE FILL IN THE FOLLOWING APPLICABLE FIELDS:

A description of the section goes here.

Name

First Last

Company

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Additional Comments or any special instructions. The more information Satake has on your product and requirements, the more effective our testing will be. Thank you.