Company Name: Contact:

Address: City: State: Zip:

End User: System Installation Date:

Phone: Fax:

Email:

Installation Environment
Indoor Outdoor	Ambient Temperature:	Altitude:	Note All Size Limitations:
Describe equipment to be lubricated, including number of points and elevations and return line elevation. Oil is returned to the system by gravity. Scavenge pump return is possible but not recommended.

Gallons per Minute:	Oil Name:	Viscosity, SSU @ 100° F:
Reservoir Capacity:	System Pressure:	Filter Micron Rating:

Select One Motor Type:				Current Available:
Open DPF.	Total Enc.	Exp. Proof	Other Specifications:	Voltage:	Hertz:	Phase:

Heat Exchanger to Remove: B.T.U.s / Hour
Water Cooled:					Air Cooled:
Oil In °F	Oil Out °F	H2O Max. °F	H2O PSI	H2O GPM	Oil In °F	Oil Out °F	Air Max. °F
Check if you need a self-operating water control valve:				Check if you need an adjustable temperature switch:

Immersion Heater:
Kilowatts	Watts / In. Sq.	Thermostat Adjust	Hours to Heat Oil °F to °F	Voltage	Hertz	Phase

Select Required Design Specificaions:	Check Optional Features Required:
Pump / Motor:    Single Dual	Pressure Switch Temperature Switch
Line Filter:    Single Dual	Level Switch(es) Flow Switch
Heat Exchanger: Single Dual	Differential Pressure Switch Across Filter(s)
Differential Pressure Gage(s) Across Filter(s)	Return Flow Sights     Needle Valves
A.P.I. Specifications:	Special Materials:

Special Instructions: