Free Flow Evaluation

General Information
P.O Number:
New Customer:
* Name:
* Company Name:
Address, Line 1:
Address, Line 2:
City:
State:
Zip:
Country:
* Phone Number:
Fax Number:
* Email:
Fluid Information
Type of Fluid:
If other, describe:
Flow Rate
Minimum Flow Rate (non-zero):   Units:  
Maximum Flow Rate:   Units:  
Nominal Flow Rate:   Units:  
Temperature:
Minimum Fluid Temperature:
Maximum Fluid Temperature:
Nominal Fluid Temperature:
Minimum Ambient Temperature:
Maximum Ambient Temperature:
Viscosity
Minimum Fluid Viscosity:   Units  
Maximum Fluid Viscosity:   Units  
Nominal Fluid Viscosity:   Units  
Density:
Minimum Fluid Density:   Units  
Maximum Fluid Density:   Units  
Nominal Fluid Density:   Units  
(Required if mass flow units are requested)
Pressure
Minimum Operating Pressure:
Maximum Operating Pressure:
Nominal Operating Pressure:
If other, describe:
Allowable Pressure Drop (if known):
Line Size
Inside Diameter:
Outside Diameter:
Nominal Line Size
Schedule:
Process
Process Connection:
If other, describe:
Accuracy
Accuracy required: % of reading:
Electronics
Power Available:
If other, describe
Output Required
If other, describe
Output Proportional To:
Display Required:
Electronic Mounting Requirements:
FM CLASS I DIV I   FM CLASS I DIV II
CSA CLASS I DIV I    CSA CLASS I DIV II
Approvals/Enclosure Ratings Required: CENELEC    CE
NONE    OTHER
If other, describe:
Notes/Special Considerations