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Dear Customer, 
In order to have better understanding about the material you are 
to transfer, please answer the questions as below. Thank you for 
your collaboration.

MATERIAL TO BE PUMPED: 
PUMPING TEMPERATURE:      C to     C
VISCOSITY @ Pumping Temperature:      C to     C
Select any of the following options that apply: 
        Poises       Centipoises
Specific Gravity:    Weight per Cubic Foot     Lbs.

CORROSIVE CHEMICAL CONTENT:
Ph value:                                  
If Acid   % Concentration Acid 

DOES LIQUID CONTAIN ABRASIVE MATERIALS?
 Yes    No 
 
SIZES OF ABRASIVE MATERIAL PARTICLES:
Inches / Centimeters Min.:
Inches / Centimeters Max.:

MATERIAL IS SIMILAR IN VISCOSITY TO 

CAPACITY REQUIRED     GPM
VARIATION REQUIRED    GPM

SUCTION LINE
POSITIVE HEAD FT. (Liquid above Suction Port of Pump)           
Variation:  Min. Ft.  Max. Ft.  
Diameter of Pipe:           Total Length:        Feet 
Vertical Feet:           Horizontal Feet: 
No. of Elbows:   90 degrees   45 degrees   Strainer Valves        

DISCHARGE LINE
Pump Discharge Pressure      PSIG
         Discharge Head      Feet 
(Vertical distance from Discharge Port of Pump to Final Outlet). 
Diameter of Pipe         Total Length         Feet
Vertical       Feet      Horizontal           Feet  
No. of Elbows   90 degrees   45 degrees  Valves  

ENTER COMPANY INFORMATION

Enter Date -- mm/dd/yy :   /   /2009  
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