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 Return Material Authorization Form (RMA)

Credit Account Application Form

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Pump Application Form

First Name(*)
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Last Name(*)
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Company Name(*)
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Title
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Address(*)
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City(*)
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State(*)
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Zip(*)
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Phone (*)
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Business E-mail(*)
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Fluid Data

Solution to be pumped
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Concentration
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% Specific Gravity
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Viscocity (SSU)
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Temperature
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Performance Data

Flow (GPM)
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Suction Lift
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Suction Pressure (PSIG)
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Discharge Pressure (PSIG)
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Differential Pressure (PSI)
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NPSHA (FT)
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Motor Data

Volts
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Hertz
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ODP
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TEFC
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Phase
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RPM
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XP
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Air Drive
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Comments/Questions(*)
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(*)

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