Survey

Please complete this short survey to receive FREE Flange Savers™ and a gift.

Name and Position *

Company *

Contact Information

Address *

Phone *

E-Mail *

Nature of Business *

Oil Terminal Details

Nature of Business - Other

Facility/Worksite Information

Number of Enclosures/ASTs *

Environment *

Inland/Industrial

Coastal

Offshore

Current Corrosion Conditions - Other

Current Method of Corrosion Protection Used *

Protective Coatings

Sacrificial Cathodic Protection

Impressed Current Cathodic Protection

Using corrosion-resistant metals/alloys

Other

Type of Coating

Describe

Current Method of Corrosion Protection Used - Other

Purpose of Corrosion Protection *

For long-term storage

For in-process Protection

Other

Duration

Purpose of Corrosion Protection - Other

Frequency of reapplication of corrosion control solution *

Less than 1 year

1-2 years

3-5 years

Other

Frequency of reapplication of corrosion control solution - Other

Next Scheduled Maintenance (if known)

Describe common corrosion problems faced in your operations *

Select the size of Flange Savers™ you would like us to send you (check one) *

	1-9	10-49	50+	N/A	Don't Know
Number of Aboveground Storage Tanks (AST)
Boilers
Heat Exchangers
Cooling Towers
Other