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:	Straight (type 1) . Side (type 2)
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:	Intermittent . Continuous.... hours on

ADDITIONAL INFORMATION

Replacement ........... New Application (specify below)

Estimated Production Date: .. .Estimated Annual Quantities:

Does pump need to restart against load?: Yes . No ..If "Yes".(specify load)

Application:

ADDITIONAL COMMENTS / INFO / Where did you hear about us?