| CUSTOMER INFORMATION |
| Company Name : |
| Contact Person : |
| Address : |
| Phone : |
Fax : |
| E – Mail : |
| PROCESS INFORMATION |
| Process Description ( In Brief) |
| |
| Fluid Name & Chemical Composition : |
| Flow Rate : |
| Operating Pressure : |
Operating Temperature : |
| Contaminant %: |
Type of Contaminant : |
| Fluid pH: |
Viscosity @ Temp: |
Sp. Gravity @ Temp: |
| FILTER MEDIA SPECIFICATIONS |
| Micron Removal Rating: |
Filter Efficiency Required : |
| Max. Allowable differential Pressure (Clean Condition): |
| Type of Filter Media : |
Bag : |
Cartridge |
Strainer |
| Currently Using Filter Media? |
Yes |
No |
If yes, of what type: |
| Filter Housing Specifications |
| Type : |
Simplex |
Duplex |
| Design Pressure: |
Design Temperature: |
| Corrosion Allowance: |
Radiography: |
| Design Standard: |
ASME Sec VII Div 1. |
Non Coded |
| Closure Gaskets/ O' ring |
Neoprene |
Viton |
Teflon Buna- N |
| End connection: |
Flanged |
NPT |
BSP |
| Housing/vessel Material |
Carbon Steel |
SS304 |
SS316 |
SS316LPP |
FRP |
| OTHER INFORMATION |
| Material of Storage Vessel : |
Material of Pipe Line : |
| Customer Inspection: Yes No. |
Third Party Inspection : Yes No |
| Proposal Drawing : Yes No. |
Approval Required : Yes No |
| Surface Finish : |
Normal |
Mirror Polish |
| Name Plate : |
Yes |
No |
| Accessories |
Air Vent |
Pressure Gauge |
Drain plug. |
| ANY SPECIFIC REQUIREMENT |
| |
| SIGNATURE AND STAMP : |
| |
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