SpiralTrac™ Adaptor Order Form

*After you have completed this form please print a copy for your own records*
**Device / pump information Equipment Information Distributor information Customer Information Comments**
*Form Type*
Product Order Request for Quotation
*Device/Pump Information*


Click on option thumbnail for larger image
Installation Option:

Units of Measurement:		Split or Solid ^{note 3} Quantity

Make and model of mechanical seal being used:

(Sleeve OD) ØA		(Box ID) ØB

(Flange Diameter) ØC		(Seal Cavity Depth) D

(Flange Length) E ^{note 1}		(First Obstruction) FO

(Nose Length) G		(To Edge of Flush Port) H

( Bolt Pattern / Diameter ) I		( Bolt Size ) J

( Packing size desired ) K

(Gasket Option) L =

J =	Min. 0.500" if split Min. 0.375" if not split	Direction of rotation viewed from the motor end:	^{note 2}

Material: ^{note 3} If other, please specify:

Notes: Min 0.625 if Split Double ended pumps require Left and Right devices. Split is now available in ESC and Metal. Sufficient flush pressure to drive a positive flow into the box is required Vertical applications sized the same way as horizontal EnviroSeal recommends that a flow meter and check valve be utilized on the flush line For no flush applications please contact EnviroSeal

*Equipment Information*
Flush: ^{note 4}If Yes, what is the flush rate? ^{note 6}
Make: Model: Size:
Product: %Solids: Temperature:
Distributor Information
Company: Specialist:
P.O.#:
Customer Information
Company:
Customer Name: Approval (Type name):
Position:
Additional Comments
Comments:
*After you have completed this form please print a copy for your own records*

	About Us \| Contact \| Products \| Support \|
Distributor Login