Information Form

• Company Name
• Country
• Contact Name
• Phone - (###) - ### ####
• Email
• Application
  PumpMarineIndustrialRailwayOther
• If Other, what application?
• Current Material
• Replaced Every (# of months)
• Part Size (approx.)
• Environmental Temperature, High
• Environmental Temperature, Low

Operating Conditions

• Oil
• Oil Type
• Water
• Water Condition (blue, silt, sand, mud)
• Other (specify)
• Cooled? Yes No
• Flowing? Yes No
• Sealed? Yes No
• Average Operating Temp (°F)
• High Temperature (°F)
• High Temperature Duration (HH:MM)
• Low Temperature (°F)
• Low Temperature Duration (HH:MM)

Shafting

• Shaft Material
• Machined Finish? Yes No
• Shaft Speed Range, Max (RPMs)
• Shaft Speed Range, Min (RPMs)
• Duration At Max RPMs
• Bearing Load Range, Max (PSI)
• Bearing Load Range, Min (PSI)
• Duration At Max Load
• Oscillating Shaft (vibration)? Yes No

Fastening

• Mechanical Press Fit
• Freeze (Press) Fit
• Mechanical Fasten (details)

Photos

• Pictures/Photos can be made available? Yes No

Quantities

• Quantity per year
• Quantity per order

• Additional Information/Notes
• Please enter the letters below