Lab Request Form

The Kice Testing Lab is able to simulate an actual system and accurately predict the viability of each product. Through testing, Kice is able to determine the proper loading and the proper air volume required for each product. Please fill out this form for processing tests through the Kice laboratory.

Requested By: *

Kice Sales Rep:

Date: *

Contact Information

Company Name: *

Contact Person: *

Street Address: *

City, State, Zip Code: *

Phone Number: *

Email Address: *

Shipping Address Same as contact information

Company Name: *

Contact Person: *

Street Address: *

City, State, Zip Code: *

Phone Number: *

Email Address: *

Test Information

RMA Number

Kice Order Number

Material Type or Description: *

Material SDS: *

Yes No

Type of Test: *

Aspiration Conveying Other

General description of test: *

Customer to witness test: *

Yes No

Requested test date:

Note: RMA number and lab test date will be confirmed after receiving completed lab test form and reviewing lab schedule.

Test Results

Would you like material samples returned?: *

Yes No

Shipping Account Number:

Note: If no shipping account is provided a $50 fee will be charged for returning small material samples < 3 lbs. Shipping larger bulk quantities will be quoted separately. Any material not returned will be disposed of within 30 days.

Please contact lab@kice.com if any questions.

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5500 N. Mill Heights Dr. | Wichita, KS 67219-2358