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:
Submerge
Splash
Other
11.Will a valve be required? Yes No
If yes, please describe:
12. Will arm service both sides of platform?
Yes No
13. Are risers flanged or threaded
14. How many risers?

Distance between risers
Please use the sketch at right to complete the following:
(A) Tank Truck (highest)
(B) Tank Truck (lightest)
(C) Center (tank truck to riser)

Max

Min
(D) Tank Truck (center to platform edge)
(E) Platform (height from ground)
(F) Riser

(G) Riser

(H) Riser
(J) Canopy to Platform
(K) Safety Rail to Riser Center
(L) Safety Rail to Truck (highest)
(X) Distance Between Risers
(Y) Centers to Fills (max and min reach)

Customer Preferences (If Applicable)
Type of Arm (Emco Wheaton Model Number)
Desired metals and seals

Flow Detector Automatic Shut-Off

Telescopic Drop Pipe Pneumatic/Hydraulic

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