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Belt Free Conveyor Application Form
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Application Form Instructions
Please complete as much of the form as possible. This will minimize un-necessary delays and allow us to get back to you faster with the correct conveyor solution.
Application Form
CONTACT INFORMATION
(* = required)
Customer:
*
Email:
*
Contact:
*
Phone:
*
Address:
Fax:
City:
State :
Zip:
Conveyor Application Data
:
Material to be conveyed:
(parts, press scrap, chips, etc.)
Can you provide samples?
-select-
Yes
No
Size of material Max:
in/mm Min:
in/mm
Rate of production:
(pcs or lbs/hr.)
Wet or dry:
If wet, describe liquid
Coolant or oil flow:
GPM
Conveyor to be submerged:
in/mm
Describe how material will
be fed into conveyor:
Conveyor will discharge into:
Max. temp. of material:
F
Material demagnification required:
-select-
Yes
No
Legs required:
-select-
Yes
No
adjustable
casters
Available Voltage:
Paint Color:
Additional Notes:
Conveyor Type:
Dog-leg
Straight
Conveyor Dimensions
W:
Width (6" minumum, 2" increment)
A:
Infeed Length (12" minimum)
C:
Discharge Length
B:
Overall Length
D:
Discharge Height
Please enter the numbers above.
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