Customer Information

Company Name:
Nature of Business:
Individual Contact:
Title:
Address:
City:
State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississppi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Country:
Postal Code:
Telephone:
Fax:
Email:

General Specifications

Media:
Media Pressure (PSI):
Rotation Speed (RPM):
Media Temperature (°F):
Union size:
Rotor thread:
# of passages:

If 2 passages are required:
Stationary siphon pipe Rotating siphon pipe
Is media filtered? Yes No

Current Application
Kind of application:
Type of machine:
Special conditions:
Present Union
Manufacturer:
Part Number:

Current problems and/or other comments:

If you would like to attach an application photo or an existing rotary union drawing, please attach here:

File to upload: