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Safety Spray Shield Request for Quotation

Due Date: Request Date:
Attention:

FROM:

Name: *
Email: *
Company: *
Phone: *
 

*Do not use hyphens when entering phone number

Address: *
City: *
State: *
Zip: *

JOB INFORMATION:

Plant Name:
Plant Locaton:
Engineer:
Bid Date:
Award Date:

EXPANSION JOINTS:

Qty. Pipe Size Rating No. of Convolutions Make & Model No. Face to Face Length

VALVES:

Flanged Socketweld Screwed End
Qty. Pipe Size Rating Gate Globe
Butterfly Ball Plug Check Diaphragm

PIPE VENT COVERS: Standard length = 12"

Qty. Pipe Size Angle Cut Straight Cut

HOSE COVERS:

Flanged Screwed End
Qty. Pipe Size Overall Length

FLANGE:

Qty. Pipe Size Rating OD Face to Face

TRANSFER LINE SLEEVE:

Qty. Camlock Size Std. Lengths
1" - 12" long
2" - 17" long
3" & up - 21" long

TYPE OF CLOTH:

 

TYPE OF METAL:

Standard PTFE Polypropylene   Galvanized
Premium PTFE PVC   304 Stainless
Single Ply PTFE Polyethylene   316 Stainless
Clear PTFE

Instructions:

*Required

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Fax this Quote Request Form to (337) 232-3860

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