|
|
|
|
PUMP APPLICATION
INFORMATION |
|
| |
Please complete as many fields as possible.
The more information that you can
provide will ensure
that we offer the best pumping solution for your needs
and hopefully we won't need to ask you any further questions.
|
|
| |
Date
|
|
| |
Company Name
|
|
| |
Title
First Name
Last Name
|
|
| |
Address
|
|
| |
City
County
Postal Code
|
|
| |
Country
Telephone
Fax
|
|
| |
E-mail
Enquiry #
|
|
| |
|
|
| |
|
|
| |
APPLICATION - What are you trying to accomplish ?
|
|
| |
How do you do it right now ?
|
|
| |
What is the problem ?
|
|
| |
Where did you hear about Doseuro ?
|
|
| |
Who is the application for ? OEM
END USER
|
|
| |
Metering (continuous)
ml (cc's) / Minute,
or
Gallons / Hour |
|
| |
Dispensing (dosing)
ml (cc's) / dispense, or
Dispenses / Minute |
|
| |
Accuracy
%,
Precision
%
|
|
| |
Discharge Pressure
psig,
or
bar
|
|
| |
Suction Pressure
psig, or
bar |
|
| |
|
|
| |
FLUID INFORMATION
| |
| |
Name
Specific Gravity
| |
| |
Viscosity
CPS, Acid ?
Base ?
Solvent ?
|
|
| |
Temperature
°F, or
°C |
|
| |
% of Solids
Size of Solids
Solids Type
|
|
| |
Shear Sensitive ? Y
N
Air Sensitive ? Y
N
|
|
| |
Precautions / Features of Fluid we
should be aware of ?
|
|
| |
|
|
| |
OPERATION
| |
| |
Continuous Duty Cycle
hours per day, over
cycles
per week
| |
| |
Alternating Duty Cycle
hours, or
mins ON,
hours, or
mins OFF,
over
days per week
|
|
| |
|
|
| |
MATERIALS OF CONSTRUCTION – FLUID PATH
|
|
| |
PVC
PVDF
PP
316 StSt
Pyrex
Ceramic
NBR
FPM
PTFE
PU
|
|
| |
|
|
| |
DRIVE INFORMATION
| |
| |
Electrical Voltage
VAC /
Hz /
Phase, or
VDC, Stepper Motor
|
|
| |
X-Proof
Pneumatic
Fixed Speed
Variable Speed
4-20mA
|
| |
|
|
| |
PLUMBING
| |
| |
Suction Port Size
Discharge Port Size
Tubing Material
|
|
| |
|
|
| |
QUANTITY OF PUMPS NEEDED | |
| |
overall, Immediately
,
in 6 Months
,
and in the future
| |
| |
| |
| |
Which
Doseuro Pump / Mixer Recommended or Interested in ?
|
|
|
|
|
|
