AZTEST ORDER FORM
      
Date:  _____________________________
Authorized by:  ______________________
COMPANY: __________________________
Address: ___________________________
___________________________________
___________________________________	
Title _________________________________
Purchase Order No.:_____________________
Phone (        ) __________________________
Fax(         ) ____________________________
E-Mail: _______________________________	

TEST SPECIFICATION:  ___________________________________________________   

SPECIMEN IDENTIFICATION:  
Part No.	Specimen ID	Size	Description	Duration	
______	_______________	__________	________________________	_____________	
______	_______________	__________	________________________	_____________	
______	_______________	__________	________________________	_____________	
______	_______________	__________	________________________	_____________	
______	_______________	__________	________________________	_____________	
______	_______________	__________	________________________	_____________	
______	_______________	__________	________________________	_____________	
______	_______________	__________	________________________	_____________	
______	_______________	__________	________________________	_____________	
______	_______________	__________	________________________	_____________	
______	_______________	__________	________________________	_____________	
______	_______________	__________	________________________	_____________	
 
SPECIMEN MOUNTING:
 Unbacked	 Backed;  Specify Backing ________________________
 Coded side to sun	 Uncoded side to sun
 Special mounting instructions: _____________________________________________

ACUVEX® ACCELERATED WEATHERING
 ACUVEX® ASTM G90 Cycle 1 (Day sprays:  8 min./hour;  Night sprays:  3 sprays/night)
 ACUVEX® ASTM G90 Cycle 2 (No water sprays)
 ACUVEX® ASTM G90 Cycle 3 (Night sprays:  3 minute sprays every 15 minutes)
 Special ACUVEX® (Specify any special moisture cycle) ____________________________________________
             
Natural Weathering
 Arizona	 Florida	 Other_______________________________________
 Direct 	 Under Glass	 Black Box
 5o South	 34o South	 45o South	 90o South	 Variable Angle		
 SAE J576	 Ford BI-160	 Other_______________________________________

GM 9538P / GM2617M / GMW 3417
Test Type:	 U/G-TSTL	 U/G-TSTLW			
Test Glass:	 Tempered 	 Laminated
Temperature:	 85oC	 93oC	 102oC	 110oC
Special: _________________________________________________________________

 Ford DVM-0020
Special: _________________________________________________________________

TEST SERVICES
Inspections:	 Weekly	 Monthly 	 Quarterly 	 Other:  __________________
Reports:	 Weekly	 Monthly 	 Quarterly 	 Other:  __________________
Color:	 Weekly	 Monthly 	 Quarterly 	 Other:  __________________
Gloss:	 Weekly	 Monthly 	 Quarterly 	 Other:  __________________
Chalk:	 Weekly	 Monthly 	 Quarterly 	 Other:  __________________
Special: ________________________________________________________________

VISUAL EVALUATIONS:
Visual Evaluations(Specify method or criteria): ________________________________________
Chalking:	 Tape Chalk	 ASTM	 TNO    Velvet Chalk   Washed   Unwashed 
Photography:	 Prints	 Slides	 Digital Image
Other Services:  __________________________________________________________ 

INSTRUMENTAL GLOSS MEASUREMENTS (Hunterlab ProGloss 3)		
 20o	 60o	 85o	 Washed	 Unwashed

COLOR MEASUREMENTS (Hunterlab Ultrascan XE Spectralcolorimeter)
 Reflectance	 Transmittance	 Luminous Trans.	 Haze	 SAE J578
 Illuminant A	 Illuminant C	 D65		 Other: _____________________ 
 2o Observer	 10o Observer	 Specular Excluded	 Specular Included
 Hunter(L,a,b)	 L*a*b*	 Spectral Data 	 Other: _____________________
 Washed	 Unwashed	 Special: __________________________________

RETURN SHIPPING INSTRUCTIONS (Name and Address): __________________________
________________________________________________________________________
SHIPPING METHOD: _________________________________________________________

ADDITIONAL INSTRUCTIONS OR REMARKS: ____________________________________
________________________________________________________________________
________________________________________________________________________

Authorized by:___________________________Title_______________Dated:______________