_ Project
* Date Entered
* Date Required
* Company
* Phone Number
* Fax Number
* City
* State
Select One
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Conneticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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
Washington, DC
West Virginia
Wisconsin
Wyoming
* Zip
* Contact Name
* Contact Title
* Contact Email Address
* Contact Extension
* Alternate Contact Name
* Alternate Contact Extension
* Product Type
Rodshaft
Internal Face
Wiper
Vane
Piston
External Face
Bearing
Non-Seal
* Special Inspection Requirements
Yes
No
* Special Packaging Requirements
Yes
No
_ Equipment Model:
_ Components: Problems:
_ Existing Seal Discription Manufacturer
_ Problem Parts Available?
* Prototype Quantity Needed
_ Customer Part Number
* Quote Quantity
_ Yearly Useage
OPERATING PARAMETERS
* Temperature (F,C,K)
* Pressure (PSI, BAR, MPA)
* Stroke Length (inch,mm)
* Cycle Rate (min,hr,hz)
* Motion (Static, Reciprocating, Rotary or Oscillatory)
* Rotation (Deg., Rad.)
* Pressure Direction (Unidirectional,Bi-Directional)
* Velocity (Ft/min.-mm/min.)
* Vacuum (In.Hg., Tor)
* Direction of Rotation(Clockwise,C.Clkwse, Bi-Direct.)
* Media to be Sealed?
HARDWARE SPECIFICATIONS
_ Hardware Drawing if Available?
_ Diameter "A" (include min. and max. dimensions)
_ Hardness, Finish & Material
_ Diameter "B" (include min. and max. dimensions)
_ Hardness, Finish & Material
_ Diameter "C" (include min. and max. dimensions)
_ Hardness, Finish & Material
_ Diameter "D" Groove Width (Min & Max.)
_ Can Hardware be Changed?
_ Dia "E" Radial Clear.(min & Max Diameter)
_ F. Rod/Piston Step Height(min & Max. dimensions)
_ Run Out (TIR- Min. & Max)
_ Eccentricity (Min. & Max.)
_ Friction (LBS,OZ or GBS)
_ Breakout/Dynamic
_ Side Load (LBS Newton’s)
_ Torque (LBS,OZ or GBS)
_ Breakout/Dynamic
_ MIL-G-5514 O-Ring Dash #
_ Back Up Width
_ AS4716 O-Ring Dash #
_ Back Up Width
_ Expected Life (Cycles/Hrs./Yrs.)
_ Max. Leakage (Drops - CC/Mins.)
_ Gland Type?
Select One
Split
Open
Solid
Stepped
_ Metric (Yes or No)?
_ Most Critical Aspect
_ Contamination
_ Additional Notes
*