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Address 1 Phone
Address 2 Ext.
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Description of application (Include type of equipment plus description of Fluid system.)
If size is unknown, specify fluid and flow rate
Fluid being conveyed
Fluid Temperature &degF Max    &degF Min.    &degF Normal
Temperature of surrounding atmosphere &degF Max    &degF Min.
Fluid Pressure PSI       Vacuum (inches Hg)
Pressure Cycle   PSI Max.    PSI Min.    Frequency
Surges (please explain)
Additional special requirements