Name:

Company:

Address:

City: State:

Zip Code:

Phone:

Fax:

email:

1. Loading Unloading
2. Pipe Size:
3. Product(s) to be handled:
4. Flow Rate:
GPM
5. Is static a concern? Yes No
6. Pressure: Positive Negative
7. Product Temperature:
8. Dry Line Wet Line
9. Is vapor and/or purge line required?
Yes No
10.Loading/Unloading Method:
Tight Fill
Splash Fill
Suction
Other
If tight fill, type connection required
Flanged
Union
Vapor Cone
Coupler/Adapter
Other
11.Will a valve be required? Yes No
If yes, please describe:
12. Will arm service both sides of platform?
Yes No
Please use the sketch at right to complete the following:
Connections to be made at the following points (indicate from sketch 1-5): If more than one connection is required:
Distance between connections
Connector Sequence
(A) Riser (drop feed) High
(B) Riser (Horizontal)
(C) Riser (Up-Feed)
(D) Center (Riser to Tank Car)
(E) Connection Height (Top)
(F) Connection Height (Bottom)
Customer Preferences (If Applicable)
Type of Arm (Emco Wheaton Model Number)
Desired metals and seals

Additional Considerations:
Distance between Risers
(K) Safety Rail to Riser Center
Risers are Flanged Threaded
Distance between Ground and Track:
Distance of Closest Obstructions
Safety Rail
Piping
Canopy
Support Beam
other
Is a Valve Required? Yes No
If yes, describe type and location:

Actuation Swivel Joint Style:
Split Flange w/spring energized seals
Standard joint w/V-ring seals
Aluminum Joint (O-ring seals only)
Steam Jacketed Joint [ ] Split Flange - PTFE Lined
Split Flange Joint with Leak Detection and
Purging Capabilities

Options for Open Dome Loading:
Automatic Shut-off
Pneumatic/Hydraulic Actuation
Telescopic Drop Pipe