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 #: |
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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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Model and Application
Details: |
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Quantity of
units required: |
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Item name / Tag
Number: |
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* Grinder Model: |
(For model selection please refer to engineering catalog or sales brochure.)
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*
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: |
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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: |
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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: |
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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