Name:

Company:

Address:

City: State:

Zip Code:

Phone:

Fax:

email:

Product to be Pumped:

Abrasive Corrosive

Desired Capacity: (USGPM)

Specific Gravity:

Operating Temperature:

Minimum: Maximum:

Normal:

Viscosity:

Minimum: Maximum:

Normal:

Suction Conditions:

Static Suction Lift: ft

Static Suction Head: ft/psi

Suction Pipe Length: ft

Suction Pipe Diameter: in.

Suction Valves, Fittings, Strainers, etc.

Discharge:

Static Discharge Head: ft/psi

Discharge Pipe Length: ft

Discharge Pipe Diameter: in.

Discharge Valves, Fittings, Strainers, etc.