
Delivery Note – Sample Fluorination
Product: __________________________________________________
Material: __________________________________________________
Dimensions / Volume: ________________________________________
Pre-treatment for
  o  Lacquering
  o  Printing
  o  Bonding
  o  Barrier layer
Required surface energy [mN/m]: ______________________________
Supplied number of sample parts: ______________________________
The samples to be pre-treated were sent by:
Name: ___________________________________________________
Company:  ________________________________________________
Address:  _________________________________________________
Phone: ___________________________________________________
E-mail: ___________________________________________________
Adress
Am Langenhorster 
Bahnhof  22
D-48607 Ochtrup
Phone 
+49 02553 9399 -0
Fax
+49 02553 9399 - 80
E-mail
info@woltering-
verfahrenstechnik.de
Internet
www.woltering-
verfahrenstechnik.de