SpiralTrac™ Order Form - Packing Version

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

Configuration: Direction of rotation viewed from bearing:

Units of measurement:

ØA (Sleeve OD)= ØB (Box ID)=

C (To edge of flush port)= D=

E (Box Length)= ØF (Counter bore diameter ^{note 3})=

G (Counter bore length ^{note 3})= Rings of packing Below=

Rings of packing Above= (3 or more ^{note
2}) FO=

Material: If other please specify:

^{Note:
When using GLF radial cross section must be greater than .500"}

Split or Solid Quantity

Flush: If Yes, what is the flush rate?

Make: Model: Size:

Product: %Solids: Temperature:

Company: Specialist:

P.O.#:

Company:

Customer Name: Approval (Type name):

Position:

Comments:

After you have completed this form please print a copy for your own records

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