Customer: Contact Name: Email: Project Reference: Phone: Fax:
Quantity: Tag # Date Required: Pipe Size: Pressure: Temperature: Media:
Configuration: Full Port Pre-Pinched Service: On/Off Modulating If Service is Modulating: 4-20mA 3-15 psi
Process Data:(To be supplied only if modulating service was checked above)
Specific Gravity of Flow: Percent Solids:
Flow Data Minimum Flow (gpm) Normal Flow (gpm) Maximum Flow (gpm) Flow Rate (gpm) Inlet Pressure (psi) Outlet Pressure (psi)
Handwheel Handwheel with Bevel Gear Pneumatic: Available Minimum Plant Airpsi
Last position Open Closed
Additional Accessories (check all that apply):
Emissions Tight Package: Manual Override: Limit Switches: Solenoid: Filter Regulator: