Pump Specification Work Sheet

Please complete the details below and submit electronically.

If you want to mail or fax the information, Click here for a pdf version.

 

Company:
Date:.......
Contact:...
Title:.......
Address:..
Address2:
City:........ .......State:
Zip:.........
Phone:.... .EExt. Fax:........ ..
Email:.....
Website:.

PERFORMANCE SPECIFICATIONS

Pump Head Type:
Type of pump: Single . Double ...If double, specify: Series or. Parallel
Flow Rate @ Specified
Pressure/Vacuum
mL/min
LPM
@ Pressure Vacuum
mm Hg
In. Hg.
In. H2O
Maximum Vacuum:
mm Hg. ... In. Hg. ... H2O
Maximum Pressure:
psi...... H2O
Pump Current: mA
Life Expectancy: Hours ..Operating Temp: °C . °F
Pump Motor Voltage: Coreless...... BrushType
Duty Cycle: hours on

ADDITIONAL INFORMATION

........... (specify below)
Estimated Production Date: .. .Estimated Annual Quantities:
Does pump need to restart against load?: Yes . ..If "Yes".(specify load)
Application: 
ADDITIONAL COMMENTS / INFO / Where did you hear about us?