Customer Information

Customer:

Attention:

Address:

City:

Province/State:

ZIP/Postal Code:

Phone:

Fax:

Cell:

E-mail:

Sales Contact:

Site Location:

Site LSD:

Design Conditions

Fluid Type: Fluid Flow:	Fluid Viscosity: Specific Gravity:
GPM m3/day LPM BD	Solids in Fluid:
Suction Pressure/NPSH: FT PSI kPa	Size in Micron: Concentration:
Discharge Pressure: FT PSI kPa	Water Analysis: Yes   No Fluid Temp:    F   C

Number of Pumps:

Single	Twin	Two @ 50%	Three @ 50%

Pump Options

Prefered Manufacturer:

Packing Material:
Non-Adjustable Adjustable Kevlar Other

Plunger Material:
Ceramic Hardco Other

Valve Style:
Delrin Disc Titatium Disc A/R

Model:

Shutdown: Low Oil Lubricator: Lubricator Pump Equipment: Suction

Vibration Day Tank Discharge

Driver Requirements

Area Classification:   Class I Div. I XP Class II Div. II TEFC Non Classified
Prefered Manufacturer:
Combustion Engine	Electric Motor
Fuel: Gas LPG Diesel Scrubber
Transmission Type: Clutch   Direct Drive
Starter: Air   12/24
Shutdown Options: Low Pressure High Temp Fuel Shutoff Low Oil Vibration

Package Options

Skid Size:
Standard Simple Skid   Building Package   Top Mount

Charge Pump	Flow Meter	Heater	Annunciator Panel
Relief Valve	Strainer	Bypass Control Valve	Filter Bypass
Filter	Suction Pressure Shutdown	Discharge Pressure Shutdown	Insulated Skid Floor
Electrical Package	MCC Provisions	Removable Pump Prime Mover Skid

Piping Options

Suction Piping:

Xray:
10% 100%
Internally Coated:
Yes No

Discharge Piping:

Pressure Test:

Corrosion Allowance:
1/16 Std. 1/8 SOUR

Building Options

Building Type: Trim: Acoustic Liner Translucent Roof Panels Removable Section Ridge Vent Whirlbirds Power Exhaust Fans Qty.: Double Doors Qty.:

Colour: Interior Liner: Door Canopies Gutters & Downspouts Ventilators Louvers Ice Rakes Single Doors Qty.: Windows Qty.:

Delivery Options

Delivery Date Requested: YY/MM/DD	Trucking:  WSS   Other
	Loading:   WSS   Other

Finance Options

Purchase    Lease to Purchase    Rent

Other Options or Comments