| Customer
Information: |
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Name: |
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| Title/Job Function: |
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Company /
Organization: |
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| *
Address 1: |
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| Address 2: |
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* City: |
* State: *
Postal
Code: |
| Country: |
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| *
Phone: |
* Fax: |
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E-mail: |
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Project
Information: |
| Customer Reference #: |
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| *
Project Name: |
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| *
Location: |
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| Engineer/Consultant: |
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| Location: |
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Due Date: |
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Project Status: |
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Estimated Date
of Purchase (Mo./Yr.): |
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Application
Details: |
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*
Quantity of
units required: |
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Item name / Tag
Number: |
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*
Rated Capacity (USGPM): |
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*
Channel Width: |
(Required for Channel
Mounted units.)
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*
Description of Liquid: |
Please include
full details, including type, size and percentage of solids, pH,
temperature, etc.
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*
Electrical Service: |
Volts:
Phase:
Frequency: |
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Product
Designation, Options and Accessories: |
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* Mounting
Type: |
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| * Motor
Options: |
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Hydraulic Drive Frame Assembly:: |
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Hydraulic Hose Pack: |
* If hose pack is required,
specify distance between Grinder and Hyd. Drive Pack.
For distances greater than 50 ft. (15.2 m) hard piping is recommended.
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Channel Mounting Rails (for single
grinder): |
(For channels 12.5" ~
14.25" in width) |
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Channel Frame Assembly: |
(Channel frames include
provisions for optional Slide Gate.) |
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Slide Gate: |
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Wet-Well Mounting Frame Assembly: |
Optional Trash Basket for
Wet-Well Frame:
Dual Guiderail Kit for Wet-Well
Frame:
Specify total guiderail length required:
Lifting Cable / Chain:
Specify total Cable/Chain length required:
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Control Panel: |
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Enclosure: |
(Contact factory for all
other enclosure types.)
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Special Features/Options: |
Please list all
special control features and options required:
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Additional
Requirements / Comments: |
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