Customer__________________   Date: ___/___ /___

Contact _________________   Territory ____________

Street Address ___________________________________

Tech Rep ________________________________________

City: _________________  State: ___  Zip: ________ Phone:_____________ 


Application Target Range:  ______# to_______# per ream______# microns film thickness

Coating Weight Measured: Wet__________	Dry__________

Ream Size: 432,000 sq. in. web/film (3000 sq. ft.) _______

144,000 sq. in. narrow web/sheet (1000 sq. ft.)  _________
  
Type Coating: Water______ Solvent________ UV__________

Coating Material: Percent Solids_____	Weight/Gallon____  pH Range_____

Viscosity________; 2Z__________# 3Z__________#	Centipoise________

Current Weight Applied:_________________________________________________

Current Anilox Type: Chrome_________ Laser__________ Mechanical_________

Line Screen/Volume:_____________________________________________________

Geometry: Quad_______  Trihelical________   30º_________  60º __________ 

Other_______________________________


Type of Coater: Flexo__________	Gravure__________

Drive System: Direct 1:1 _________	Variable Speed__________

Metering System: 2-roll  _________	Reverse Angle Doctor Blade______

Enclosed Doctor Blade   __________	Trailing Blade___________

********************************************************************************************

                  HARPER CORPORATION INTERNAL USE ONLY


Volume Needed on Substrate: _________________________________________BCM

Calculated Deposit Efficiency: ____________________________________________%

Recommended Anilox Volume: ________________________________________BCM

Recommended Line Screen: ______________________________________________L/S

Harper Corporation of America 11625 Steele Creek Road, PO Box 410369, 
Charlotte, NC 28241-0369 Ph: 704-588-3371 / 800-438-3111 Fax: 704-588-3819