General Pump

CONTACT INFORMATION


Company
Telephone
Fax
E-mail
Would you like to be contacted by a representative to discuss the application?		Yes
		No
Is this a replacement for an existing system?		Yes
		No
Number of Systems

APPLICATION INFORMATION

Application Name (will be referred to on all correspondence
Liquid to be Pumped (if other than water)		SG (if known)

Requiremnets	GPM		PSI
Duty Cycle Hours	On		Off

FLUID SUPPLY

Temperature	°	F C
Static Pressure		PSI

Dynamic Pressure With Flow At Twice The Application

GPM

PSI

Maximum Available GPM

GPM

Gravity

City

Feed Pump

Well

If Chemicals Are To Be Used Please
Provide Trade Name, pH and % Solution
to Be Injected Into The Supply

ELECTRICAL SUPPLY

Voltage(s)		HZ
Phase		Amperage

ACCESSORIES

Discharge (please check)
Regulator/Unloader (required)
Gauges (required)
Flow/Pressure Switches
Pulse Pump
Guns
Lances
Other

ADDITIONAL INFORMATION:

SUBMIT CLEAR