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Blastox ^® Project Registration Form

The Blastox ^®Warranty is contingent upon the contractor registering each project, after award, with The TDJ Group, Inc. Registration must be prior to the start of the project and prior to purchasing Blastox ^® blended abrasive. Registration can only be accomplished by completing this form and providing it to The TDJ Group, Inc. All information is confidential between TDJ and the contractor.

Contractor Information

Contractor Company		Contact
Address		Title
		Phone
City, State, Zip		FAX

Project Information

Structure Owner		Engineering Company
Project Name		Engineering Contact
Project City, State		Engineering Phone
Structure Type:		(If other, describe)

Square feet to be abated		Anticipated tons of abrasive
% Blastox to be used		Dry Blast Wet Blast
Test blast TCLP (if known)	mg/l	Blast Equipment Used
% of lead in paint to be abated		Rust Inhibitor for Wet Blast

Type of abrasive		Abrasive supplier
Estimated start date		Estimated completion date
Disposal facility		Lab to run TCLP

The TDJ Group, Inc. 760-A Industrial Drive Cary, IL 60013
Voice (847)639-1113 e-mail: tdj@blastox.com FAX (847)639-0499