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CONTACT INFORMATION
Please complete as much information as you can
CUSTOMER
INFORMATION
NAME:
COMPANY NAME:
LOCATION:
PHONE:
E-MAIL ADDRESS:
DO YOU HAVE AN EXISTING SPECIFICATION SHEET?
Yes
No
IF SO, Please attach spec
sheet with response
VALVE
DETAILS
Valve Quantity:
Line Size:
Type (ball, plug, etc):
Flange Rating:
Flange/Connection Type:
Pressure Vessel
material of construction:
Valve Trim
material of construction:
Uni-Directional /
Bi-Directional:
Cavity Relief:
Reduced / Full Bore:
Throttling / On-Off:
Temperature Range
(Operating, Max/Min):
Inlet Pressure
(Operating, Max design):
Pressure drop / differential
(Normal, Max design):
Media (chemistry, viscocity,
vapor pressure, density):
Normally open or closed?
Actuation frequency
(open closed cycles):
Dormancy (expected
period between cycles):
Inlet Pressure
(Operating, Max design):
Total thermal swing, speed
frequency of transient):
Fugitive Emissions
Requirement:
Fire Safe
Requirement:
Applicable Codes of
Construction (B16.34 ...):
NACE Requirement:
*
Indicates Response Required