Application Form

Basic Info

1. First Name
2. Last Name
3. Title
4. Company name
5. Mailing Address
6. Suite Number
7. City
8. State
9. Country
10. Zip
11. Area Code and num
12. Ext
13. Area code and fax
14. Email(valid email required)

Process Fluid

1. Name

Process Conditions

1. Line Size
2. Pressure
3. Temp
4. Density/Specific Gravity
5. Viscosity
6. Describe upstream piping conditions
7. Minimum flow rate
8. Maximum flow rate
9. Abrasive
10. YesNo
11. Solids
12. YesNo
13. If solids, indicate percent

Application

2. MeasureMonitorControlMass balance

Preferred Differential Primary Element

2. VenturiLo-Loss® Flow TubeFlow NozzleOrifice PlatePitot Tube
3. Other - Please list

Performance criteria

1. Accuracy + or -
2. Repeatability + or -
3. Max permanent pressure loss
4. Minimum differential

List other technologies being considered

Project status

2. PlanningBudgetaryPurchase in 3 monthsPurchase in 6 monthsPurchase in 1 year

Follow up

2. Please call to discussPlease send literaturePlease have local rep call

Additional comments

1. Ten minus five equals