CLEANING PRODUCT APPLICATION FORM

Civility MissMister

Your surname*

Your name*

Working company*

Activity of the company*

Function*

Adress*

Postal code

City*

Country*

Phone number*

Your e-mail*

What do you want to decontaminate?*

Dirt type?*

Presence of sensitive metals?*
YesNo

Cleaning equipments

Operating temperature of the equipment?* (°C)

Is the equipment explosion-proof?*
YesNo

Ultrasound?*
YesNo

Do you already use solvent based cleaning product?*
YesNo

Do you already use aqueous based cleaning solution?*
YesNo

Reference(s)?

ABchimie
Z.A. La Rivoire – 38630 CORBELIN
Tel 04 74 83 12 19 – Fax 04 74 83 68 62
info@abchimie.com

A clear and precise identification of your needs will allow us to guide you to one of our specialists in this field. Do not hesitate to inform us as soon as possible.