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Customer Information:

Name:*

Title:*

Plant:*

E-Mail:*

Phone:*

Fax:

Address:

City:

State:

Zip Code:

Unit Information:

Unit Size (MW):

# of Burners

Boiler Type (Wall Fired, Tangential, etc):

Current NOx Level:

(lb/mmBtu)

Desired NOx Level:

(lb/mmBtu)

Current Economizer Outlet:

O2% CO ppm

Burner Information:

Burner Type:

Burner Manufacturer:

Burner Heat Input:

Primary Fuel:

Secondary Fuel

General Information:

Problem Description or Case Study Requested:

Have an ACT Engineer call to discuss the problem in detail. Yes No

Send Me an Evaluation Report Based on the Information Above of Potential NOx Reductions and Estimated Cost. Yes No

Send Me Some More Information About ACT. Yes No