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CDI Pump Quotation Request Form

This extensive form is meant to allow Chemical distributors to supply you with a quotation in the shortest amount of time possible. Please fill in as much of this form as possible.

ABOUT YOU
Name:
Company:
Address:
City:State:Zip:
Phone #:Fax #:
Email:
PUMP APPLICATION:
Material to be pumped:
Temperature of material:
Other notes on material (such as solids content, viscosity, specific gravity, particle sizes, etc...)
SUCTION PARAMETERS
Pipe diameter (inches):Pipe length (vertical length in feet):
Pipe length (horizontal length in feet):Number of elbows:
Number of valves:Is there a strainer used?:
Other factors affecting the suction side:


DISCHARGE PARAMETERS
Flow rate required (in gpm):Pressure required (in psi):
Max discharge head (in psig):Pipe length (vertical length in feet):
Other factors affecting pump performance not addressed above:


80 Metcalfe Street * Buffalo, NY 14206 * (800) 777-CHEM (2436)* (716) 856-2300 * Fax - (716) 856-7115

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