Pump / Equipment Demonstration Request

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Pump / Equipment Demonstration Request

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First Name

Last Name

Phone

Company

Address Line 1

Address Line 2

City

State

Postal Code

How would you prefer to be contacted?

Phone

Are you interested in a particular type of pump - mixer - system?

Product Demonstration Details:

Name and Type of fluid to be pumped:

Viscosity:

Include Unit of Measure

Min. Temp:

Include Unit of Measure

Max. Temp:

Include Unit of Measure

Desired Flow Rate:

Include Unit of Measure

Desired Pressure:

Include Unit of Measure

Does the product contain solids?

Yes

What are the solids:

Solids details:

Settling	Floating	Abrasive
Delicate	Stringy	Binding

Average Solids Size:

Include Unit of Measure

Is the product shear sensitive?

Yes

Not sure

Does this fluid require special material considerations? (e.g. all PTFE seals, all PTFE construction, 316SS construction, etc.)

Is the product being pumped out of a drum, IBC or other container in your process?

YesNo

What type of container is it?

BucketDrumIBC / ContainerOther

Size:

Include Unit of Measure

Straight or Tapered?

Straight

Tapered

Max. Diameter:

Include Unit of Measure

Min. Diameter:

Include Unit of Measure

Is this a sanitary process?

Yes

Describe the process the product is being or will be used in:

Preferred Date:

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Contact Information