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Pump Enquiry Form

Client Name:

Date:

Field	Application 01	Application 02
Pump Tag No.
Pump Application
Liquid Name
Sp. Gr.
Viscosity (Cp)
Temperature (°C)
Head (Meter)
Suction (Flooded/Negative)
Flow (M³/Hr)
Slurry	Yes No	Yes No
Percentage (%) of Slurry
Size of Particle
Metallic/Non-Metallic
Horizontal/IMS/Mag Drive Sealless
Required Motor FLP/NFLP

Remark:

Details of Current Pump

Make:

Model:

HP/RPM:

MOC:

Problem with Current Pump: