Mobile Bottling Work Order

all fields required unless otherwise noted

Customer*
Address*
Street Address Address Line 2 City State ZIP Code
Contact Name*
First Last
Title*
Phone*
Email*
Fax
(optional)
Cell*
Additional Contact
(optional)
First Last
Requested Bottling Date*
Line*
- #1
- #2
- #3
- #4
Bottling Site Address*
- Same as billing address
Site Information
Site Description*
Select all that apply
- Paved
- Gravel
- Level
- Outside
- Covered
- Inside
- Plenty of room
- Tight on space
Space Assessment*
Please check the appropriate box
- Only space for Lines #1 & #3
- Plenty of space for all lines
Locked Gates?*
- Yes
- No
Gate Code
(if applicable)
Electric Power*
Select all that apply
- 230 v. 3ph // 100amp
- 208 v 3ph // 100amp
- 230 v. 3ph // 60amp
- 208 v. 3ph // 60amp
- 480 v 3ph // 60amp
- 480 v 3ph // 30amp
- Generator 45kw 3ph - Minimum
- Plug Available
- Pigtail into Service Disconnect
Water Source*
- Well
- City-supplied
- 30 psi and 10 gpm or better
- Other (complete additional details below)
Additional Water Info
(if applicable)
Services & Supplies
Typical services offered: Bottle type: i.e., Hoc, Claret, Burgundy, etc. Please use a prefix of ” T-“ (for tapered). Please provide glass supplier, bottle type, diameter at the bottom for straight glass and bottom & shoulder diameter for tapered, and mold #. This info can be emailed or faxed separately and is needed at least 7 days prior to your bottling dates. Bottle sizes: 375 thru 1.5L (up to 14.0” Max. Height for cork), and 1.0L jug. Closure Type: Cork - Natural, Synthetic, Aglo or Screw Cap. Foil type is either Tin or Poly-Lam. Filter types: 1.2/.5/.45 or stainless screen (S/S), or supplied by Customer (C/S).
I would like TIOB to supply:*
- Bar code/case labels
- Laser Coding
- Nitrogen Drip
- Heat Shrink Tunnel/PVC
- None of the above
Label Specs
Tapered Glass MUST have tapered labels on SEPARATE webs to be properly applied.
- #-3-Off Right
- #-4-Off Left
- Face & Back on same web
- Face & Back on separate webs
Wine # 1 Details*
Estimated Cases Wine Description Bottle Type Bottle Fill Size Bottle Diam + Ht Mold # Closure Type Foil Label - Y/N Filters
Wine #2 Details
Estimated Cases Wine Description Bottle Type Bottle Fill Size Bottle Diam + Ht Mold # Closure Type Foil Label - Y/N Filters
Wine #3 Details
Estimated Cases Wine Description Bottle Type Bottle Fill Size Bottle Diam + Ht Mold # Closure Type Foil Label - Y/N Filters
Wine #4 Details
Estimated Cases Wine Description Bottle Type Bottle Fill Size Bottle Diam + Ht Mold # Closure Type Foil Label - Y/N Filters
Wine #5 Details
Estimated Cases Wine Description Bottle Type Bottle Fill Size Bottle Diam + Ht Mold # Closure Type Foil Label - Y/N Filters
Wine #6 Details
Estimated Cases Wine Description Bottle Type Bottle Fill Size Bottle Diam + Ht Mold # Closure Type Foil Label - Y/N Filters
Wine #7 Details
Estimated Cases Wine Description Bottle Type Bottle Fill Size Bottle Diam + Ht Mold # Closure Type Foil Label - Y/N Filters
Wine #8 Details
Estimated Cases Wine Description Bottle Type Bottle Fill Size Bottle Diam + Ht Mold # Closure Type Foil Label - Y/N Filters
Wine #9 Details
Estimated Cases Wine Description Bottle Type Bottle Fill Size Bottle Diam + Ht Mold # Closure Type Foil Label - Y/N Filters
Wine #10 Details
Estimated Cases Wine Description Bottle Type Bottle Fill Size Bottle Diam + Ht Mold # Closure Type Foil Label - Y/N Filters
Additional Info
(optional)

Please call (707) 252-3330 and speak with Bill Crawford, Director of Mobile Operations regarding any questions or concerns.

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