Materials Test Request for Simplicity Blenders

SA# Sample Name

Bulk Amount of Sample

Density Submitted
(min 50lbs)
(regrind: min 200lbs)
MSDS Type of Testing
Sheet Requested

Number

**When mailing sample please mark the package stating SA# provided to you by CRG
Logics, Inc.**
Customer Name & Location:

PROCEDURE OF RETURN: (How to dispose of material once tested.)

TESTING REQUEST: Exact testing request and general description of testing required.

*MSDS Sheet is required to send this sample to CRG Logics, Inc. if not provided will be
returned.

Please send sample to:

CRG Logics, Inc.
Attn: William Smith
610 Baeten Road
Green Bay, WI 54304
(920) 884-7400 Main Line