18 Regan Rd.

, Units 28 & 29
Brampton, ON CA L7A 1C2
Telephone: 905-840-6800
Fax: 905-840-6799
conflow@conflow.ca
www.conflow.ca

APPLICATION FORM

Date:

Company:

Company Contact:

Address:

Tel: (

Fax: (

Sales Person:

Gas

Description:

Industrial

Sanitary

Cryogenic

Viscosity:

Cp/cstk/SSU @

PH:

% solids

Flowrate (gal/min):

Min:

API
Specific Gravity:

which pass thru

Max:

Liquid

mesh screen

Steady Variable Pulsating

Norm:

Temperature ( F): Min:

Max:

Norm:

Time @ Max:

Pressure (psig):

Max:

Norm:

Max allowable drop:

Min:

Clean-in-Place: Yes No Liquid:

Piping:

Size:

Rate (gal/min):

Material:

Flow Source (please check):

Temp ( F):

Preferred End Fitting:

Positive Displacement Pump

Tank (gravity feed)

Time:

Sch:

Centrifugal Pump

Diaphram Pump

Other:

Accessory Interface (please check):

Engineering Units:

Resolution:

Rate Display

Batch Control

Totalize

Local

Remote

Temperature Compensation

Pressure Compensation (Gasses)

Record

0-5VDC

Transmit 4-20

0-10VDC

Hi/Lo Alarms

UVC
Transmit Specify:

Mass Flow Control

Computer Interface/Specify:
Enclosure Need:

NEMA Type:

Hazardous Environment:

Comments:

1 (General Purpose)

4 (Waterproof)

Wall Mount

Panel

Yes No

Class:

Div:

7 (Explosion Proof)