Blacoh Surge Suppressor Application Data Sheet

First Name

Last Name

Phone

Company

Address Line 1

Address Line 2

City

State

Postal Code

How would you prefer to be contacted?

Phone

A Surge Suppressor is required for:

Surge Suppression

Thermal Expansion

Additional Thermal Expansion Data

Initial System Pressure:

Include Unit of Measure

Maximum Allowable System Pressure:

Include Unit of Measure

Initial System Temperature:

Include Unit of Measure

Maximum Expected Fluid Temperature:

Include Unit of Measure

Coefficient of Cubical Expansion of Fluid Per Degree:

Include Unit of Measure

General Information

Pump Make:

Pump Model:

Material of Construction:

Pipe Diameter:

Include Unit of Measure

Length of Pipe Horizontal:

Include Unit of Measure

Length of Pipe Vertical:

Include Unit of Measure

Name of Liquid Pumped:

Temperature:

Flow Rate:

Include Unit of Measure

Specific Gravity:

Include Unit of Measure

Viscosity (mPas, cPs or SSU):

Include Unit of Measure

Line Operating Pressure:

Include Unit of Measure

Quick Closing Valve:

Yes

If Yes, Type of Valve:

Coefficient of Linear Expansion of Pipe per Degree:

Include Unit of Measure

Pipe Material:

Upload Process Drawings, Sketches or Other Files Here

Aflas	Buna-N	EPDM	Hypalon	Neoprene
Polyurethane	PTFE	PVC	Santoprene	FG Silicone
FKM	Don't Know

Alloy 20	Aluminum	Carbon Steel	Hastelloy C	Polypropylene
PVC	PVDF	Stainless Steel	Don't Know

Alloy 20	Aluminum	Carbon Steel	Hastelloy C	Polypropylene
PVC	PVDF	Stainless Steel	Don't Know