Customer information:

Name:
Title:
Company:
Address:
City, State & ZIP:
Phone:
Fax:
E-mail:

Hydraulic application:

Description of hydraulic components required:

Click here if a circuit schematic is available, then please fax it to: (815) 399-5528.

Operating conditions:
Normal operating speed: pressure time on time off
Maximum operating speed: pressure time on time off

Type of hydraulic fluid:

Fluid conditions:

How is pump driven?

What does motor drive?

Hydraulic: Gear Pump Motor Proportionator
Displacement:
1st section 2nd section
3rd section 4th section

Port sizes and locations:

Mounting flange type, size:

Shaft description (type, size):

Rotation direction:

Valving:
Valves required:

Relief valve settings:

Electrical:
Motor type, voltage:

Start switch:

Reservoir mounting filtration:
Reservoir capacity:

Mounting requirements:

Envelope restrictions:

Filtration:

Prototype qualification test:
Cycles:

Pressure:

Other:



Number of units required:
Mo. Qtr. Other
Prototype required


Please provide any additional information: