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Name
*
First
Last
Company
*
Email
*
Title
*
Zip Code
Phone
Web Site
Number of Cleaning Lines
Total Volume of All Cleaning Lines (gallons)
Total Gallons of Cleaner (neat) Used per Year (gallons)
Washer Tank Dump Frequency (days)
Temperature (F)
pH
Type of Soil (Check all that apply)
Water based lubricant
Oil based lubricant
Stearate
Other
Please describe if "other" is checked.