Iwaki Air AODD Pump Application Worksheet

AODD PUMP APPLICATION WORKSHEET
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SECTION ONE
CHANNEL PARTNER INFORMATION
(if end-user, please see Section Two)

Channel Partner Company Name

Contact Name

First Name

Last Name

Direct Phone / Cell Phone

Location

SECTION TWO
END USER INFORMATION

End User Company Name

Contact Name

First Name

Last Name

Direct Phone / Cell Phone

Location

SECTION THREE
APPLICATION DETAILS

Project Name / Number

Fluid Name or Chemical Name (if proprietary, please attach SDS)

Fluid Concentration (%)

Operating Temperature (degrees F)

Viscosity (if known) (cps)

Specific Gravity (if known) (SG)

Flow Required (GPM)

Head Pressure (ft)

Solids Present (YES/NO)

Solids Max. Size (in)

Air Pressure Available (PSI)

SECTION FOUR
Any Additional Comments or Remarks About This Application

SECTION FIVE
Current or Proposed Layout Sketch or Drawing
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