Gear Pump Data Form for Quotation Melt Pump Data Form for Quotation Company Name Contact Name Street Address 1 Street Address 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Zip Country AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAustrian EmpireAzerbaijanBadenBahamas, TheBahrainBangladeshBarbadosBavariaBelarusBelgiumBelizeBenin (Dahomey)BoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBrunswick and LüneburgBulgariaBurkina FasoBurmaBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsChadChileChinaColombiaComorosCongo Free State, TheCosta RicaCote d’Ivoire (Ivory Coast)CroatiaCubaCyprusCzechiaCzechoslovakiaDenmarkDjiboutiDominicaDominican RepublicDuchy of ParmaEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGrand Duchy of TuscanyGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHHaitiHanoverHanseatic RepublicsHawaiiHesseHoly SeeHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKingdom of Serbia/YugoslaviaKiribatiKoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMecklenburg-SchwerinMecklenburg-StrelitzMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueNamibiaNassauNauruNepalNetherlands, TheNew ZealandNicaraguaNigerNigeriaNorth MacedoniaNorwayOldenburgOmanPakistanPalauPanamaPapal StatesPapua New GuineaParaguayPeruPhilippinesPiedmont-SardiniaPolandPortugalQatarRepublic of GenoaRepublic of the CongoRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSchaumburg-LippeSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTajikistanTanzaniaTexasThailandTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluTwo SiciliesUgandaUkraineUnion of Soviet Socialist RepublicsUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamWürttembergYemenZambiaZimbabwe Phone Number Email Address Product(s) of Interest General Purpose Melt Pump (EGP) Chemical / Adhesives Melt Pump (CIP) High Pressure Melt Pump (HGP) Fluorinated Polymer Melt Pump (FGP) Pump Rebuild Drop-In Replacement Pump: PSI or Maag, Witte, Nordson/Xaloy/Dynisco/Normag or Other Brand Type of Application or Product Made Material Melt Index SG @ Melt Temp (If Known) Output Rate Lb/hr or kg/hr lbs/hrkg/hr Fillers (enter None, if none) Filler Percent by Weight Process Temperature Deg. F or C FC Viscosity Viscosity Unit of Measure Pa.s (pascal seconds)P (poise)cP (centipoise) Inlet Pressure PSI or Bar PSIBar Discharge (or Die) Pressure PSI or Bar PSIBar Type of Heat ElectricFluid Heater Voltage if Applicable Heater Phase 1Ph3Ph Melt Delivery Single Screw - Non-Vented Single Screw - Vented Twin Screw - Co-Rotating Twin Screw - Counter-Rotating Truck Vessel Tote Other Extruder Size Inch or mm inchmm Are Upstream and Downstream Detail Connection Drawings Available? Yes No Unknown Comments Send
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