Product Selection and Application Worksheet
Customer Name:
"[Click here and type company name]"
Contact Phone:
"[Click here and type phone]"
Customer Contact:
Address:
"[Click here and type contact name]"
"[Click here and type address]"
Contact Fax:
Contact Email:
"[Click here and type fax]"
"[Click here and type email]"
Project / RFQ#:
"[Click here and type project info]"
Job Location:
"[Click here and type job location]"
Date:
Quantity Requested:
"[Click here and type date]"
"[Click here and type quantity]"
Please fill in items 1 through 7 to properly specify the medium to be measured (please indicate units of measurement)
1) Fluid Type/Chemical
Composition or Mixture
2) Gas or Liquid?
3) Fluid Temperature Range
( MIN. / MAX. /TYPICAL )
5) Fluid Viscosity (or viscosity
range if available)
6) Ambient Temperature Range
( MIN. / MAX. )
Please note units:
SG kg/m33, lb/gal,
lb/ft3, etc
Note Celsius,
Fahrenheit
4) Fluid Density
Note Units
6) Molecular Weight:
(for Gas only)
Note Celsius,
Fahrenheit
7) Compressibility (gas only):
Please fill in items 8 through 13 to properly specify your application requirements (please indicate units of measurement)
8) Pressure
(Minimum)
(orifice)
9) If Flow (please specify)
10) Diaphragm Seal
(None)
(venturi)
(Normal)
(annubar)
(No Preference)
(Maximum)
(pitot tube)
(cone)
Please note units
other
(Yes) - Specify Need
Fill type
12) Application:
(NPT)
( Flanged) others (specify) :
Pressure ( ) Diff Pressure ( ) Temp ( ) Flow ( )
13) Other
"[Click here and type other info- open/closed tank, pump pressure, filter DP etc]"
11) Process Connection
Please indicate
units for flow
Size : (specify)
Level ( )
Other ( )
Specify: P/T/F/L
Any attachments
Y()
Please fill in items 14 through 26 to specify (fill only if FLOW application)
14) Meter Type Required:
15) Line Size:
17) Meter Material:
18) Throat Material:
20) Pipe Schedule:
21) Process
Connection:
23) Flow Rate ( min/nor/max)
24) Multivariable?
16) Meter Orientation:
19) Flange Material:
22) Area Classification:
(yes or no)
25) Transmitter Connection:
26) Other Details:
AAI Sales Approval: _______ AAI Engineering Approval: _________ AAI Operations Approval: __________
AAI Ref: _______ CPC Code: _________
Autrol Corporation of America.
2521 Technology Dr, STE 201, Elgin, IL 60124 USA
T: (847) 779 5000 or (847) 857 6062 F: (847) 655 6062 Email: proposals@autroltransmitters.com
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