Check & Relief Quote Form

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Company Name*

Individual Name*

Title

Email*

Telephone*

Extension

FAX

Address*

City*

State*

Zip*

1. Describe your application

2. Relief Valve Type: (check all that apply)

Direct Acting: Poppet Type

Direct Acting: Differential Area

Cartridge Type

Other

1. Fluid*

2. Pressure: Operating psig

Proof psig

Burst psig

3. Cracking Pressure PSID

4. Minimum Flow at Cracking Pressure, specify GPM, SCFM, or PPH

5. Full Flow, specify GPM, SCFM, or PPH

6. Full Flow Pressure Drop PSID

7. Reseat Pressure PSID

8. Leakage Allowed at Reseat cc/min

9. Leakage Allowed at 75% Cracking Pressure cc/min

10. Operational Life in cycles

1. Max. solenoid size: length

width

depth

specify inches or cm

1. Temperature min, specify: F or C*

Media Temperature max, specify: F or C*

Quote on following quantities: Prototype*

Production*

Price Range per unit (Target)

Annual

Date this quote is required by

Remarks