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*Customer Name:

*Telephone:

Fax:

*Application/Project Name:

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Service Requirements

Capacity Required:

GPM at discharge pressure:

PSID

Operating Temperatures:

Duty Cycle:

Intermittent

Continuous Material Requirements:

Cast Iron Stainless Steel

Relief Valve: Yes No

Seal Requirements:

Other Information:

Liquid Data

Liquid Name:

...at Temperature:

F C

Viscosity:

SSU CKS CPS

Specific Gravity:

Characteristics:

Clean Dirty Acidic Solids

Other Information:

Prime Mover/Power Data

Horsepower: RPM:

Phase: 01 03

Hertz: 50 60 Dual

Voltage: AC DC

Mounting: Close Coupled Bedplate

Motor Frame:

Enclosures: ODP TENV TEFC EXPP Washdown Other

Additional Application Data:

Inlet Conditions

Conditions: Flooded Dry Wet Vacuum In. Hg.:
Ft. Lift: Ft. Head: Ft. Pipe Length: Pipe Diameter:

Other Information: