Application Data Form

Application Data Form/Continuous Level Gauge

Please complete this form to help us understand your process better.
Company Name
Contact Name
Street or PO Box		Zip Code
City		Phone
State/Province		Fax
Date
eMail
PROCESS SPECIFICATIONS (Please include units of measure when not already specified.)
Product
Product density	SpG
Dense vapors or gases above product? Yes No
If yes, give approximate density: SpG
Normal product temperature
Ambient temperature
Operating pressure	PSIG
Measuring range
Continuous Level Interface
Density Product 1
Density Product 2
Dense vapors or gases in the measurement range? Yes No
If yes, give approximate density: SpG
Foam in the measurement range? Yes No
If yes, give approximate density: SpG
Physical Arrangement
Vessel	Horizontal Vertical
Vessel inside diameter
Wall thickness steel
2nd wall material and thickness
3rd wall material and thickness
Refractory brick	Yes No
If yes, provide density
Insulation material and thickness
Agitator?	Yes No
Buildup material?	Yes No
Approximate thickness
Hazardous Area Classification?
HART Communications Required?	Yes No
Purpose of gauge

Required delivery time
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