Application Data Sheet


APPLICATION DATA SHEET

Customer Information:
Customer Name:		Date:

Address:

City:

State:

Zip:

Contact:

Phone:

Fax:


Product Information:
Product name:	Foaming?	Yes	No

Specific gravity

Viscosity

(Centapoise)

Temp

Area electrical classification

Class

Division

Group

AIT

Working pressure at the filler:

PSI

Flow rate:

GPM

Is material toxic or caustic?

Yes

Is material for human consumption and requires 3A or FDA specs?

Yes

Is material corrosive?

Yes

If yes, what material is recommended for the wetted parts?

316SS stainless steel piping with Teflon seals are used for all wetted parts. All structural parts, controller, and scale base are made of mild steel. Provide any information as to special characteristics of materials (ie. explosive, hardens, carcinogenic).

Requested cycle time

minutes

Fill tolerance +/-

increments*

*Normal system fill accuracy is 3 increments on a 3 sigma basis.

Drumfiller location requirements:

Electrical power available:

VAC,

Is compressed air available?	Yes	No
Is air pressure less than 90PSI?	Yes	No
Is an air dryer in use?	Yes	No
Is a recirculating line used with the pump?	Yes	No
Is the ambient temperature less than 32�F?	Yes	No
Is the ambient temperature greater than 104�F?	Yes	No
Is the area a corrosive or washdown area?	Yes	No

Materials required for scale base: Mild steel

Stainless steel

Other

Is this system using a gravity or powered conveyor?

Gravity

Power Conveyor

If conveyor, give height:

What is the maximum ceiling height where the drum filler will be located?

Please complete the above information and print it before going on to the next page. Make sure to complete the container information on the next page before leaving.

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