Name *

First Name

Last Name

Phone Number *

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I’m interested in the Liquid product(s) indicated below

(Available sizes indicated next to each product)

Clay Fix NV (5 gal can)

Clay Slick (5 gal can)

Clay Thin (5 gal can, 4x1 gal case)

Liquid Clay Fix (5 gal can, 4x1 gal case)

Klean Det (5 gal can)

Size/Amount (for liquid products)

Sample

5 Gal Can

4 x 1 Gal Case

Im interested in the Powder product(s) indicated below

(Available sizes indicated next to each product)

Clay Fix H (14 lb pail, 35 lb pail, 25 kg bag)

LCM (30 lb bag)

Pac-L Plus (40 lb pail, 10x2 lb pail)

Pac-R Plus (40 lb pail, 10x2 lb pail)

Pretreat (50 lb bag)

Suspend-All (10x2 lb pail)

Size/Amount (for powder products)

Sample

14 lb Pail

35 lb Pail

30 lb Bag

25 kg Bag

50 lb Bag

40 lb Pail

10 x 2 lb Pail