Sample of Assembly Lubricant - International Products Corporation

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Lubricant Sample Request Form

Name(Required)

First Last

Title

Email(Required)

Phone Number(Required)

Company Name(Required)

Job Category

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please provide VAT # (Europe Only)

Please provide EORI code (Europe Only)

Please briefly explain your assembly application(Required)

Does your lubricant need incidental food contact application approval?

Yes

How did you hear about us?

I would like someone to call me to discuss my cleaning application

Yes

Would you like to receive technical information about our lubricant products?

Yes

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✓ = Used ; ✓ = Preferred

SOILS	Micro-90®	Micro® Green Clean	Micro® A07	Surface-Cleanse/930®	LF2100®	Zymit® Low-Foam	Zymit® Pro
Adhesives	✓	✓		✓	✓
Biofilm	✓	✓		✓	✓
Biological soils: Blood, Feces, Mucous, Sebum, Sweat, Urine	✓	✓		✓	✓	✓	✓
Dyes, Inks	✓	✓		✓	✓		✓
Eggs, Butter, Fruit Stains	✓	✓			✓	✓	✓
Emulsifiers	✓	✓		✓	✓
Fat	✓	✓		✓	✓
Fingerprints	✓	✓		✓	✓	✓	✓
Flavor, Fragrances	✓	✓		✓	✓
Gelatin						✓	✓
Gels	✓	✓		✓	✓	✓	✓
Grass	✓	✓			✓	✓	✓
Insoluble Salts			✓
Milkstone	✓	✓	✓		✓	✓	✓
Oils	✓	✓		✓	✓
Oxides	✓	✓	✓		✓
Paraffins	✓	✓		✓	✓
Petrolatum	✓	✓		✓	✓
Proteins						✓	✓
Scale			✓
Shop Dusts, Soldering Flux	✓	✓	✓	✓	✓	✓	✓
Silicons	✓	✓		✓	✓
Starch						✓
Tar	✓	✓		✓	✓
Tissue						✓	✓
Titanium Dioxides	✓	✓			✓