*** Application Data Sheet ***

Company:
Address:
Your Name:
Telephone:
Fax:
E-mail?:
1. Application.  Please describe the task:

             
Will the monitoring system control pumps 
or other equipment?      
If yes, what equipment?
  [ ] Yes     [ ] No 

Will it be used for inventory information only?
Is control required during filling?
  [ ] Yes     [ ] No 
  [ ] Yes     [ ] No

2. Tank.
Is tank vertical ____ ?   If yes, how high  ______ ? Closed top ___ ? Open top ___ ?
If vertical, is bottom:  Flat _____ ?  Dished _____ ?  Conical _____ ?  Other _____ ?
Is tank horizontal ____ ?  
Tank diameter is:  ___________ 
Temperature inside: __________ degrees   [ ] F     [ ] C
Are there heating coils inside?        [ ] Yes     [ ] No  
Pressure inside:  _____________
Any obstructions inside the tank?   [ ] Yes    [ ] No 
If there are obstructions, describe:

Is there a mixer inside?      [ ] Yes   [ ] No
Is there air agitation?         [ ] Yes   [ ] No
Does tank top vibrate?      [ ] Yes   [ ] No
3. Media Inside.
Name liquids that will be monitored:
Explosive?  [ ] Yes   [ ] No
Class I ?     [ ] Yes   [ ] No
Foam on surface? [ ] Yes  [ ]  No
Corrosive?   [ ] Yes   [ ] No
Fumes?        [ ] Yes   [ ] No
Vapors?       [ ] Yes   [ ] No

4. Sensor (Transducer) Position.
Sensor distance from tank side wall: __________
Does inlet pipe enter tank from:  [ ] Top      [ ] Bottom        [ ] Mid-height
Will inlet pipe cause splashing under transducer?    [ ] Yes    [ ] No
Vertical distance from sensor face down to tank bottom: __________
Diameter of opening (nozzle) where sensor would be mounted: _________
Length of this nozzle (standpipe): ___________
If tank is horizontal, is the opening in the tank vertical centerline?  [ ] Yes    [ ] No
Approximate distance between sensor and the control box (controller): ________
5. Sensor (Transducer) Housing.
[ ] Standard PVC        [ ] CPVC             [ ] Teflon 
[ ] 316 stainless steel    [ ] Explosion-proof (316 ss)      [ ] Kynar
6. Outputs.  (mark all requested)
[ ] Level display  [ ] Volume display  [ ] 4-20 mA current  [ ] No. of set points___
[ ] RS232C  [ ] Modem
7. Is this tank monitored now?     [ ] Yes     [ ] No
If yes, what product are you using?
Is the present monitoring satisfactory?
Any comments?

Please print this page, fill and fax to:  941-964-2902
Or, call us at 941-964-1361 and we will fax you a blank form. Thank You!
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