Please note: if you are accessing this page from an offers website, you may wish to consider that this offer is for industrial detergents and is not intended for household use.

If our standard sample which makes 1 gallon (3.8 liters) of test cleaning solution will not be enough for your sample evaluation, please e-mail cleaning@alconox.com.

To help us send the right samples for your application, please check all boxes that apply, or fill in where indicated.

Items in red are required.

What surfaces are you cleaning?

Polycarbonate, acrylic, and other sensitive plastics
Filters, membranes, RO or UF systems
PC boards, wafers, electronic components
Pipets in syphon washers
Soft metals: aluminum, copper, brass, other non-ferrous
Stainless steel, iron, nickel
Glass, ceramic, porcelain, rubber, fiberglass, plastic
Other
If 'Other', please describe:

What soils are you removing?

Proteinaceous soils, blood and other body fluids, tissue
Inorganic soils, scale, salts, metallic complexes, metal oxides, trace metals
Silicone oils, mold-release agents, buffing compounds, radioisotopes, radioactive contaminants
Oils, cutting fluids, chemical, solvents, bio-residues, particulates, laboratory soils
Heavy oils, greases, baked-on residues
Conductive residues, resins, rosins, solder, fluxes, particulates, salts
Other
If 'Other', please describe:

What would you use the cleaner for?

Floor, walls, cookware
Labware
Field sampling equipment
Other re-usable items/instruments
Filtration Membranes
Large manufacturing equipment
Manufactured Items
Selling/Distribution
None of the above

How are you cleaning?

What type of cleaner do you want to use?

Liquid cleaner
Powder cleaner
Either / Not sure

If you clean by immersion, how?

Method	Brand	Age (yrs)
By Hand
Soak or circulate clean-in-place
Syphon pipet washer
Power spray wand
Ultrasonic
Other Non-spray

If you clean by machine, which do you use?

Type	Brand	Age (yrs)
Glassware washer
PC board washer
CIP spray
Parts washer
Washer/sanitizer
Power spray wand
Solvent vapor/soak
Other

Is there an acid rinse cycle?

If you use cleaning machinery, are you planning to purchase new, upgrade, or replace it in the near future?

What size/how often do you purchase high-quality cleaners?
units (single boxes or bottles)	Frequency:
cases (of boxes or bottles)	Frequency:
medium sizes (50-100 lb or 5-15 gal drum)	Frequency:
bulk sizes (300 lb or 55 gal drum)	Frequency:

Detergent
Do you currently use an Alconox, Inc. detergent?

Please specify what you currently use:

Issues, Comments, Concerns

Are you are currently experiencing problems with the cleaner you are using?

Any special waste treatment/disposal concerns?

Please identify your principal activity:

If 'Other', please describe:

Your primary job function:

If 'Other', please describe:

Estimated annual purchases of high-quality cleaners (if known):
(in US $):

Are you willing to receive hazardous corrosive liquid detergent samples if the questionnaire indicates that they should be tested for your application?

Special complimentary book offer - $39.95 value - The Aqueous Cleaning Handbook

I agree to try the samples being sent as a result of this request
I agree to let Alconox know the results of my sample trial by completing the sample report card (will be included with samples)
I understand that I will be billed $39.95 for the book if I fail to try out and report the results of my trial

Please SEND me the Aqueous Cleaning Handbook. I agree to terms stated above.

If you wish to purchase the book, please order it on
our website or call Alconox, Inc. at 1-877-877-2526.

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