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): Kg/m3 lb/cu. ft Moisture Content (%): Temperature: °C °F Angle of Repose (Degrees): Surcharge angle (Degrees) Pre-Feed (Supply Sketch if possible) Application: Load, Speed, Rate, and Total Rate Control Batch Control Ratio Controlled Blending Feed Type: Rotary Valve Vibratory Pan Screw Belt Other Bin or Hopper Bin Size Feed Rate: min. t/hr lb/hr LTPH STPH max. t/hr Nominal t/hr Accuracy required: +/- % Electrical classification at scale location: Condition of operating Environment: Duty Cycle: Wash Down Sanitary Corrosive Hours per day Weighfeeder: Space limitations: Length mm inches Width Height Construction: Open Closed Access side looking in direction of belt travel: Left Right Both Inlet dimensions: (LxW) mm inches Centerline Length: (Inlet to discharge)mm inches Installation: 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 Comments/Notes Please note any special instructions, considerations or requirements: Form # 2-773R0
Form # 2-773R0