Leak-Tec Engineering

1.) Product tested for leakage:  
     a.) Size              b.)  Material                         c.) Volume  
2.) Number of units tested daily:   
3.) Pressure              Vacuum
4.) Problem Is:         Production             Maintenance             Other   

5.) Type of Leakage:          Liquid            Gas            Other   

6.) Test Pressures Available:

7.) Temperature (Fahrenheit)
8.) Present Testing Method
9.) Present Test Apparatus
10.) Leakage now found at the following points:
11.) Leakage Rate:
12.) Problems with Present Test
13.) Percentage Leakers:           Rejects           Work Over            Other  
14.) Additional Comments or Requirements:
15.)    Company Name:

          Your Name:

          Email Address:

          Telephone Number: