Brechbuehler Inc.: Request form

Brechbuehler, Inc specializes in customization of GC and GC/MS systems.
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Tel. +1 281 880-6963
Cell: +1 281 541-4112

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Company*
Name*
Address*
City
State
ZIP
Tel
E-mail address*
Budget available?		yes No
If yes how much?
Time frame for purchase
		Sample information Sample information
Components to be analyzed
Sample type (CTRL click for multiple selection)
Sample pressure
Sample temperature
		Analyzer requirements Analyzer requirements
Standard method (ASTM, ISO, Etc...)
Prefered injections (gas,liq, LPG, Headsapce)
Number of sample per day
		Autosampler required
		Stop flow valve required
		Back pressure requlator required
		Is method development requested?
Prefered column
Will you supply a test sample?		Yes No
Do you already analyze this sample		Yes No
If yes please provide details of method, GC brand, Columns, etc...
Comments/remarks
		Please type in the letters below