Solder analysis submission form

Instruction:

1. Fill out the this form
2. Take a sample of 50 - 75 gram from the solder process
3. Clearly identify the material in such a way that sample and identification can not be separated
4. Pack each sample separately in a strong bag (several bags can be combined in 1 box)

Title *	Mr Ms
First name *
Last name *
Company *
Email *		Your PO nr.
Sample id 1*		Date *		Alloy *	SAC305 SAC405 SACX0307 SACX0807 SnPb SnPb with desoxidant SACX0300 with desoxidant Other
Sample id 2*		Date *		Alloy *	SAC305 SAC405 SACX0307 SACX0807 SnPb SnPb with desoxidant SACX0300 with desoxidant Other
Sample id 3*		Date *		Alloy *	SAC305 SAC405 SACX0307 SACX0807 SnPb SnPb with desoxidant SACX0300 with desoxidant Other
Sample id 4*		Date *		Alloy *	SAC305 SAC405 SACX0307 SACX0807 SnPb SnPb with desoxidant SACX0300 with desoxidant Other
Sample id 5*		Date *		Alloy *	SAC305 SAC405 SACX0307 SACX0807 SnPb SnPb with desoxidant SACX0300 with desoxidant Other
Sample id 6*		Date *		Alloy *	SAC305 SAC405 SACX0307 SACX0807 SnPb SnPb with desoxidant SACX0300 with desoxidant Other
If you chose 'other' for Alloy, please specify in the messagebox.
Message
Enter code *