Recorder Order Form Bill To: Ship To: Phone: Fax: CHART

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CHART RECORDERS & DATALOGGERS
Recorders Pricing Effective January 1, to April 30, 2016
Note! Click here for details on State Restrictions of
Mercury Added Products BEFORE accepting orders
for any products containing mercury.
RECORDER ORDER FORM
For Better Than Normal Delivery (BTND) check with Production before quoting!
Bill To:
Ship To:
Phone:
Fax:
Recorder Order Form
Model Number:_________________
Case
Mount
Door
Qty:________________
Price
Add $
See PL
$________
8"___
12"___
Wall___ Pedestal___ Flush___ Portable___ Pelican Case Portable ___(8" only) Pipestand___
Draw Pull Latch with Hasp standard on Wall, Pedestal and Portable. Black Knob standard on Flush
Glass ___ Plexiglass ___ (Std on Pelican) Solid ___ (POA for Pelican) Shatter-proof Glass ___ (POA) $________
1
$________
Optional Door Stop ___ (Std on Pelican Case)
1
Optional Double Latch Bar with Padlock type Handle (Solid Door included) ___
Optional Black Knob ___ 1 (POA)
Hammertone Grey (Std) ___ Optional: Black Wrinkle ___
White ___
$________
$________
Pelican Black (Std) ___
$________
$________
Included
Paint
Other (Specify) ________________________________________
Pens
POA
One ___ Two ___ Three ___ (Note: Top (1st) Pen tracks Arc Line unless indicated otherwise)
(Fill in: Red, Blue or Green)
$________
Included
Top:_____________ Middle:_____________ Bottom:_____________
Pen Color
One spare Pen included in the appropriate color for each pen specified. (Add as separate line item)
Pen Type
Felt Tip Pen (Std)
Chart Size
8" - 6-3/8" Arc Line (Std) ___ 12" - 6-3/8" Arc Line (Std) ___ 1
Other: (Please Specify) _____________
Included
Box of 100 charts included. Fill in Part Number____________________________*
No Charts: indicate Chart Number to calibrate to ______________ (Required Field)
In Stock Charts, Standard Lead Time for Recorder and Charts
Out of Stock Charts, add approx 2 weeks to Lead Time for Recorder and Charts
If quicker Lead time is needed, Pkg of 10 Percentage Charts may be substituted: #______________
Included
Chart #
SPECIAL OFFER - on Special Order Charts at time of Recorder purchase only:
additional boxes Special Order Charts (100/box) $19.75 each, No minimum, No Discount**
(Add) $19.75/bx
PC-11 Multi-speed (Std) Set ON: Min: 60, 96, Hours: 12, Days: 1, 2, 7, 8, 14, 16, 31, 32 (circle)
PC-12 Multi-speed (Std) Set ON: Min: 30, Hours: 1, 2, 4, 6, 8, 12, Days: 1, 2, 3, 4, 7, (circle) (Add)
Spring Wound: (725 RO84) Choose Speed: 24 Hr. ___
Clock
7 Day ___
$________
Included
$________
(Add)
$________
Optional Spring Wound: (725 RO86) Choose Speed: 15 Min. ___
1 Hr. ___
(Add)
POA
$________
Optional Spring Wound: (725 RO77) Choose Speed: 2 Hr. ___
8 Hr. ___
(Add)
POA
$________
Optional Electric Clock, 120V: Choose Speed: 12 Hr. ___ 24 Hr. ___ 48 Hr. ___7 Day ___
(Add)
POA
$________
Optional Electric Clock, 220V: Choose Speed: 7 Day ___
(Add)
POA
$________
Linkage
Wire (Std)
Included
Pen Arm
Fixed (Std)
Included
POA - Priced on Application
Subtotal Price Each:
$________
* Check both IN STOCK Charts on Price List, and inventory before quoting lead time.
CSR-015, Rev W: 05/01/16, RecorderOrderForm_CSR-015
**Add as separate line item.
1
not on Pelican Case.
59
(800) 421-2853 • FAX (828) 658-0728 • www.palmerwahl.com
CHART RECORDERS & DATALOGGERS
Recorders Pricing Effective January 1, to April 30, 2016
RECORDER ORDER FORM
Note! Click here for details on State Restrictions of
Mercury Added Products BEFORE accepting orders
for any products containing mercury.
For Better Than Normal Delivery (BTND) check with Production before quoting!
Pressure Systems
Pressure Range
Pressure
Elements
Pressure
Connection
Top Pen:_________
Middle Pen:_________
Bottom Pen:_________
High Pressure 316SS Helical Coil: PSI: 30# - 75# ) _____ (1/4" NPT Female Connection)
PSI: 100# - 10,000#) _____ (1/4" NPT Female Conn),
_____ Optional Autoclave Fitting on 10,000#
PSI: 15,000# - 20,000#) _____ (9/16"-18 UNF High Pressure Female Autoclave Fitting)
PSI: 25,000# - 30,000#) _____ (9/16"-18 UNF High Pressure Female Autoclave Fitting)
Bar Charts available. Contact Customer Service for information.
Low Pressure Diaphragm Element: PSI: 1# - 25# _____ (1/4" NPT Female Conn)
3# to 15# PSI _____ (Receiver) (1/4" NPT Female Conn)
oz/in2: 10___ 15___20___25___ 30___50___ (1/4" NPT Fem. Conn)
$________
(NC)
POA
$________
$________
$________
$________
$________
$________
$________
KPA: 5__ 20__80__100__ 500__ 800__1000__ 2000__5000__ (1/4" NPT Female Conn)
$________
inHG: 10"___ 30"___50"___ (1/4" NPT Female Conn)
$________
inH2O: 10"___ 15"___ 20"___ 25"___ 30"___40"___50"___ 60"___100"___ (1/4" NPT Female Conn)
$________
(1/2" NPT Female Connection and additional Adaptors are available upon Request)
$________
Bottom ___ Back (Lower) ___ Latch Side ___ Hinge Side___ Top ___
Other (Specify) _________________________________(See Pricing for Std Pressure Connection)
Temperature Systems
Temperature Range Top Pen:_________
Middle Pen:_________
Bottom Pen:_________
Included
Temperature Element (Select)
A) Armor:
304 Stainless Steel Flex Armor - 5 ft (Std) ___
- Total length if over 5 ft = ______ Add for each foot (Call over 25 ft) Total feet over 5 = _____ft. X
Optional: 304 Stainless Steel Bendable Stiff, 3/16" diameter - 5 ft (Std)
- Total length if over 5 ft = ______ Add for each foot
Total feet over 5 = ______ft. X
Included
$________
Included
$________
#AWR-3694 - Gas Industry Std 10.5" x .625" diameter Bulb with 1/2" NPT SS Adjustable Union ___
45-5 ____
45-11____
45-12____
Included
B) Bulb Type:
45-13 - Specify Bulb Length: 4"____, 6"____ (Std), 8"____, 12"____
45-14 - 1/2" NPT ____ (Std)
3/4" NPT ____ (Opt) 1/2" Dia ____ (Std)
45-29 ___
5/16" Diameter ____
3/8" Diameter ____
45-30 ___
5/16" Diameter ____
3/8" Diameter ____
5/8" Dia ____ (Opt)
Note: Bulbs over 12" Add for each 6" or fraction thereof:_________
Temperature
Connection
Location
Bottom___
Back (Lower) ___
Latch Side ___
Hinge Side ___
$________
Top ___
Other (Specify) ______________________________(See Pricing for Std Temperature Connection)
Valving & Test Connections (or with Quick Disconnects)
Internal Valving
Per Drawing:
Pedestal Mount
2-1/2" Slip On___ 3" Slip On___
Thermowells
(N/C)
Included
Gas Industry Std, 1" NPT External, 1/2" NPT Internal, 304SS - add as below:
CP-970-1-1, 4-7/8" overall length ___
(Add)
CP-970-1-2, 5-7/8" overall length ___
(Add)
CP-970-1-3, 7-7/8" overall length ___
(Add)
CP-970-1-4, 11-7/8" overall length ___
(Add)
Other: (See Palmer Thermowells Catalog) Model # ___________________________________
TOTAL Price Each:
POA - Priced on Application
Prices and Specifications are subject to change without notice.
60
3" Threaded ___
$________
$________
$________
$________
$________
$________
CSR-015, Rev W: 05/01/16, RecorderOrderForm_CSR-015
(800) 421-2853 • FAX (828) 658-0728 • www.palmerwahl.com
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