| Customer
Information: |
| *
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: |
| *
E-mail: |
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| |
|
Project
Information: |
| Customer Reference #: |
|
| *
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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| |
|
Model and Application
Details: |
|
*
Quantity of
units required: |
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|
Item name / Tag
Number: |
|
| * Grinder Model: |
(For model selection please refer to engineering catalog or sales brochure.)
|
|
*
Channel Width (inches)
: |
(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.) |
|
*
Electrical Service: |
Volts:
Phase:
Frequency: |
| |
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|
Mounting Configuration , Options and Accessories: |
|
* Mounting
Type: |
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| * Motor
Options: |
|
|
Channel Mounting Rails (for single
grinder): |
(For channels 12.5" ~
14.25" in width) |
|
Channel Frame Assembly: |
(Channel frames include
provisions for optional Slide Gate.) |
|
Slide Gate: |
|
|
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:
|
|
Control Panel: |
|
Enclosure: |
(Contact factory for all
other enclosure types.)
|
|
Special Features/Options: |
Please list all
special control features and options required:
|
| |
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|
Additional
Requirements / Comments: |
|
|
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