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Company Name*

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Email*

Address*

City*

State*

Zip Code*

Classification*
UserDistributor/ResaleOEMExport

Liquid Name

Concentration %

Specific Gravity

Viscosity (cP)

Fluid Temperature (°F)

Vapor Pressure (PSIA)

Minimum Temperature (°F)

Max Temperature (°F)

Solids

Percentage

Type

Normal (GPM)

Minimum (GPM)

Maximum (GPM)

Suction Pressure (PSIG)

Discharge Pressure (PSIG)

Total Dynamic Head (Ft)

Differential Pressure (PSIG)

Suction LiftFloodedVacuum

NPSHA (Ft)

MAWP - Max Allowable Working Pressure (PSI)

Specified Materials:

Impeller/Gear/Vane:

Bearings:

Case/Housing:

Shaft/Sleeve:

Elastomers - Gasket/O-Ring:

Seal:

MechanicalComponentPacking

Seal Construction (i.e. seal faces, elastomers, etc.):

Flush Plan:

Flanges or NPT Connection:

150# RF150# FF300# RF300# FFNPT

Flange or NPT Size (Suction/Discharge):

Baseplate:

Carbon SteelStainless SteelCorosion ResistantOtherNone

If other, please specify:

Special Piping, End Connections:

Special Data or Drawings?

Shop Inspection:

Hydrostatic Test:

Performance Test:

Drive Type:

ElectricHydraulicEngine DrivenAirNone

If Air Driven, Plant Supply Air Available (PSI)

Power:

ACDC

Voltage:

Phase:
SingleThreeN/A

Hertz:
50 Hz60 HzVariable Speed

Area Classification:

Non-Classified (General Purpose)Classified (Hazardous)

If Hazardous, Please Specify Requirements and Classification:

Area:
IndoorOutdoor