Online Application
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Company Name: Date:
Contact: Email Address:
Address:
City: State: Zip: Country:

1. Fluid Name or Type:

2. Capacity Required: GPM or GPH

3. Viscosity: CPS

4. Temperature: F

5. Pressure, Suction: PSIA

6. Pressure, Discharge: PSI

7. Solids %: Solids Size:

8. Solids Type (soft, hard, abrasive, sticky, etc) :

9. Suction Dia./Length:

10. Discharge Dia./Length:

11. Operation: Hrs./Day

12. Intermittent Continuous

13. Metering Batching

14. Fixed Speed Variable Speed:
Max Flow: GPM or GPH
Min Flow: GPM or

15. Speed Controller Req'd: Yes No

16. TEFC Motor Explosion Proof Motor

17. Volts/PH/HZ:

Any Other Application Notes:

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