Questionnaire for selection of the correct type of hose

The more detailed the description of the type of hose you require, the more easily we can make you the right offer from

among our approx. 620 hose types in diameters from DN 50 mm ( 2") to DN 5080 mm (200").

1,0

MEDIUM

/ What will pass through the hose ?

1,1

Gas ? O or Air ? O

1,2

Powder ? O or Granulate ? O

1,3

Liquid ? O

1,4

Chemically aggressive ?

Yes ? O or No

1,5

For what purpose ? See pages 23, Column A

2,0

TEMPERATURE

( if no safety margin is indicated, we add on a safety margin )

2,1

ƒC

ƒC = ƒFx 0,56 -18 ; Constant temperat.

2,2

ƒC

Peak temperature

3,0

PRESSURE / 1 mbar = 10 mm WC = 100 Pa (Pascal)

3,1

+

mbar

overpressure, at what diameter ?

�

mm

3,2

-

mbar

vacuum pressure, at what diameter ?

�

mm

Vacuum pump ? O or Ventilator ? O

4,0

DIAMETER

Quote only internal diameter of a hose ( 1" = 25,4 mm )

4,1

�

mm

Please list all required diameters

4,2

�

mm

or indicate smallest + largest diameters

For BELLOW EXPANS.JOINTS + EXPANS.BELLOWS only

5,1

mm

Maximum length

and

5,2

mm

Minimum length

5,3

Vertical ? O or horizontal fitting ? O

6,0

INTERESTED PARTY / CLIENT / CUSTOMER

Date

6,1

Company

6,2

Person to contact

6,3

Town

|

6,4

Adress

6,5

Phone

|

6,6

Fax

CLIP-LINE^Æ

^{Schlauch-Technik + Schalld”mpfung GmbH}

^{Phone + 49 - 209 - 6 000 260}

^{PB: 200 150, D-45 836 GELSENKIRCHEN}

^{Fax ..- 6 000 550}

^{Items 7,0 + 8,0 will be completed by CLIP-LINE !}

^{T ( in 7,0 + 8,0 ) = hose type no., see pages 14 + 24, Column 1 !}

7,0

Price - Quotation 1

T

Nr.

8,0

Price - Quotation 2

T

7,1

Hose type

8,1

7,2

Quantity x unit length

8,2

7,3

Delivery time ex works D.

8,3

7,4

List price

8,4

7,5

Price factores.See pag.13

8,5

7,6

8,6

7,7

8,7

7,8

8,8