Page 59 - GarlockFluidSealing2010

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Application Data Form
For quotation or application recommendations, simply copy this page, fll it out entirely and mail or fax it to Garlock
or to your local authorized distributor.
Date:_ _____________________________________
Name:_ ______________________________________ Company:_ _________________________________
Phone No.:_ __________________________________ Fax No.:____________________________________
Pipe Size:_ ___________________________________ Control Units?:_______________________________
Temperature:__________________________________ Hydrostatic Testing?:__________________________
Pressure/Vacuum:______________________________ Replacement?: For What Style?:_ _______________
Media:_______________________________________ Comments:_ ________________________________
Movements - Compression:______________________ _ _________________________________________
Elongation:________________________ _ _________________________________________
Lateral:___________________________ _ _________________________________________
Face-to-Face Dimension:_ _______________________ _ _________________________________________
Drilling (if other than 125/150 Ib.):__________________ _ _________________________________________
Retaining Rings:_ ______________________________ _ _________________________________________