SKALAR

APPLICATION QUESTIONNAIRE SP2000

Documentnr.: PLOG-012-02 Revision: 4/15 January 2014

Please fill in this form completely and send together with your order to Skalar
SKALAR ANALYTICAL BV
P.O. BOX 3237 Your order no. : ___________________________________
4800 DE BREDA
THE NETHERLANDS Reference to Skalar quotation number: _______
Tel: +31(0)76-5486486
Fax: +31 (0)76-5486400 Date : __________________________________

Analysis

Please specify the required measuring range and the Standard Regulation Number*

Component to analyse Range Standard Regulation No.*

COD

Remarks:
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* If procedure deviates in detail from the standard, please specify deviation at remarks

System voltage: O 110V/60Hz System plugs: O (USA style plug) O (UK style plug)
O 220-240V/50Hz O (European style plug) O (Danish style plug)
O 380V/50 Hz O Other
O Other

Installation required: O No O yes, by Skalar Holland

Training required: O No O yes, at Skalar Holland O yes, at customer

Existing user: O yes, please send details (orderno., copy of software, etc.) of the existing analyzer O no
The specifications in this Application Questionnaire shall prevail over all other specifications mentioned in other forms, as in your written order.

Enduser :______________________________ Tel :___________________________________

Department :______________________________
Contactperson :______________________________
Address :______________________________
:______________________________
Country :______________________________
Fax :___________________________________
E-mail :___________________________________
Signature:__________________________________

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Hardware Section 1

If hardware parts are supplied by the end-user to Skalar, please specify the brand and the model number:

- Meter Brand

Model number

- Sample vials Brand

Model number

Dimensions

- Sample racks Brand

Model number

Dimensions

- Computer Brand

Model number

- Brand

Model number

Remarks:
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Software

QC control

Please select and specify the QC standards required for QC control for each parameter:

Parameter
Value Range/Delta
O QC 1
O QC 2
O

Table layout specifications

- Seq. Sample sequence

- PosInRack Sample position in rack
- Identity Sample identity
- Range Sample range
- Type Sample type
- Y/N Question measure sample yes or no
- Sample Measured sample values
- Calc.Sample Calculated sample value
- Average Average sample value
- C init Sample temperature at the start of the digestion
- C final Sample temperature at the end of the digestion
- Pre-dilution Pre-dilution factor
- Dilution Automatic sample dilution factor
- Date/Time Date and time of the measurement
- Error Error message
- Method Used method for calculation

Please specify if additional information in the table layout is required

Column name Description Calculation example (if required)

O
O
O
O
O

Remarks:
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Import /Export function (example of an import/export file is required)

Remarks:
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Automated Measuring Procedure for Chemical Oxygen Demand (According ISO 15705 and EPA 410.4)
Please check and approve the automated measuring procedure. If the measuring procedure is not according the
expected procedure, please indicate the differences or explain the desired measuring procedure.

*The procedure will be provided by Skalar Analytical BV and will be according the offered
procedure/configuration

Procedure steps marked with # are performed by the operator.

Yes No (Please clarify the selection)

Method approved O O

Remarks:
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Additional information

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