Customer Information: Date: Contact Name: Company Name: Company Address: Address (cont.): City: State/Province: Zip/Postal Code: Country: Work Phone: FAX: E-mail: Prepared By: Notes on the application: Material: Material being measured: Particle Size: mm inch mesh Bulk Density: Kg/m3 lb/ft3 Moisture Content (%): Temperature: °C °F Is Material aerated?: Yes No Material properties: Hygroscopic Corrosive Easily aerated Abrasive Other Material flow characteristics: Smooth Sluggish Sticky/Clumping Other Application Information: Feed Rate: min. t/hr lb/hr LTPH STPH max.t/hr lb/hr LTPH STPH Normal t/hr lb/hr LTPH STPH Accuracy required: +/- % Pre-feed Type: Rotary Valve Belt Screw Vibratory Pan Aerated gravity conveyor Bucket Elevator Other (Specify) Flow Rate: Constant Variable Pulsing Flowmeter will discharge into: Headroom available: ft/min Temperature at flowmeter: max min C F Sensing Plate subjected to air flow: None Some Material test can be performed: Yes No Estimated Distance from pre-feed discharge to flowmeter: mm inches Electrical classification at in flowmeter environment: Integrator Requirements: Power Available: Inputs Required: (check all that apply): 4-20 mA LVDT Variable Speed PID Load Cells (#): Outputs Required: (check all that apply): 4-20 mA PID Remote totalizer Relays (#): Communications: AB Remote I/O DeviceNet Profibus-DP RS232/RS-485 Modbus Preferred Products: Preferred Construction: (flowguide and sensing plate enclosure): Painted Mild Steel 304SS 316SS Other (specify) Comments/Notes Please note any special instructions, considerations or requirements: Form # 2-772R2
Form # 2-772R2