Application Data Form/Clamp On Density Gauge

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Before a quotation can be issued, we should have this form completed. 
Company  Name 
Contact Name 
Street or PO  Box  Zip Code 
City  Phone 
State/Province  Fax 
Date 
eMail

PROCESS SPECIFICATIONS
Product Slurry  NonSlurry Process Material
Density Range to Unit:
Accuracy % of span
Accuracy  G/L
Normal Product Temperature degrees C
Temperature Range to degrees C/F
Ambient Temperature degrees C
Solution Slurries
Density Solvent Carrier Density
Solute Density Solids Density

Physical Arrangement     
Nominal Pipe Diameter inches
Schedule
Inside Diameter mm
Outside Diameter mm
1st wall thickness mm Material
2nd wall thickness mm Material
Insulation Thickness mm Material
Liner Thickness mm Material
Hazardous area classification    
HART communication required?     Yes    No
RETROFIT If this is a retrofit where an existing source will be used, we will need to know:
Size of existing source (mCi)
Isotope of existing source (Cs 137, Co60, etc)
Original Date of Source
Source Supplier

                                            

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