New Pump Quote * Required Information |
| Company Name |
* |
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| Contact Name |
* |
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| Address |
* |
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| Address |
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| City |
* |
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| State |
* |
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| Zip |
* |
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| Phone Number |
* |
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| Alternate Phone |
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| Fax Number |
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| E-mail Address |
* |
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| Are you replacing an existing pump? YES
NO
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If YES, please give any applicable details…
(Existing pump brand and model number, connection
size and style, material of construction, conditions of
service, serial number, etc.)
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| Briefly describe your pumping needs.
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Describe the liquid(s) being pumped.
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What flow is required?
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What is the Total Discharge Pressure or
Total Dynamic Head required?
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| Is the liquid source below the pump inlet?
YES
NO |
| Please describe any solids that are in the liquid by
type, size, and concentration.
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| Temperature of Liquid:
Degrees
Fahrenheit
Celsius |
| Is the liquid flammable?
YES
NO |
| Viscosity of liquid (if applicable):
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| Specific gravity (if applicable):
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| What type of pump drive is required?
(Electric, Hydraulic, Air Motor, Gas Engine, etc.)
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| If it is an electric motor, please describe any details
such as duty cycle, motor enclosure, voltage
required, AC or DC, phase, hertz, etc.
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Verification Code *
Enter the black characters found in the above image.
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