Company name
Contact person
Email address
*
Phone number
*
Address
Street Address
City
State
Country
Enter your country
Postal Code
Bottle Size
2 oz (60 ml)
4 oz (120 ml)
8 oz (240 ml)
16 oz (500 ml)
32 oz (1 L)
Quantity for 2 oz Bottles
Quantity for 4 oz Bottles
Quantity for 8 oz Bottles
Quantity for 16 oz Bottles
Quantity for 32 oz Bottles
Other size
Total quantity
Recurring order?
Yes
No
Intended HOCL Use
Cosmetic (skin mist, cleanser, toner)
OTC (first aid, wound care)
Food sanitation
Contact surface sanitation
Other use
Desired Concentration (PPM)
50 ppm
100 ppm
150 ppm
200 ppm
250 ppm
300 ppm
350 ppm
400 ppm
450 ppm
500 ppm
Other PPM
PH Range
4.8 – 6.4 (standard cosmetic range)
6.4 – 7.0
Other ph range
Preferred delivery / completion date
Special notes or instructions
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