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	Form #: 851-07402 A
PRODUCT ENGINEERING INFORMATION SHEET

To assist Applied Ceramics in providing better products, please provide as much information to the best of your knowledge regarding the part characteristics and technical requirements. Once you have completed this form, please press the red print button and include a copy of the form with the part and send to: Applied Ceramics, Inc. - Samples Dept. - 850 Corporate Way - Fremont, CA 94539
Sender & Return Info:
Company Name:
Contact Name:		Title:
Phone:	Fax:	Email Address:
Address1:
Address2:
City:	State:	Postal Code:	Country:
Do you request for this part to be returned?	Yes No
Is Destructive Material Testing Allowed?	Yes No
Cleaning Required?	Yes No
If the return address is different than above, please provide below:
Company:		Attention:
Address1:
Address2:
City:	State:	Postal Code:	Country:
Part Info:
Company Part Number:		Reference Part Number:
Part Description:		Quantity:
Tool Set Name:		Annual Usage:
Quantity Required for Qualification:
Sample Status:
Sample Condition:Used New		Comments:

Part Characteristics / Technical Requirements

*NOTE: Please be specific in regards to all below

1. Material:

2. Critical Surface Requirements:

(Example: Sealing Surface, Rough Texturized Surface, etc.)

3. Critical Dimensions:

(Example: Thickness, Height, Depth, Diameters, Intersection Points, Critical Edges or Corners, etc.)

4. Critical Form:

(Example: Roundness, Flatness, Parallel, Perpendicular, etc.)

5. Critical Alignment - Feature Relationship within Part:

(Example: Slot Location to Hole Pattern, etc.)

6. Fit to Matching Part Relationship:

(Example: Positional, Rotational)

7. What are the Controlling Features?

(Example: Outside Diameter + Slot)

8. Fit Constraint (Maximum or Minimum):

(Example: Height, Length, Diameters)

9. Where is the Part Located in the Tool?:

10. What are the Critical Operating Parameters that Affect this Part?

(Example: Temperature, Pressure, Other)

11. What Surfaces are Exposed to the Process?

12. What are the Known Failure Modes of the Part?

13. What is the PM Frequency of the Part?

14. What Specific Improvements Would Engineers Recommend for this Part?

Once you have completed this form, please press the red print button and include a copy of the form with the part and send to: Applied Ceramics, Inc. - Samples Dept. - 850 Corporate Way - Fremont, CA 94539