Name:
Email:
Phone:		Fax:
Address1:
Address2:
City:
State/Province:	Zip Code/Postal Code:
Country:
Company:
Title:

1. Heater type:
   • Immersion
   • In-Line Heater
   • Heat Transfer System
2. Product being heated:
   
3. Cylindrical tank dimensions:
   • Diameter:
     
   • Length:
     
   • Height:
     
4. Rectangular vat dimensions:
   • Length:
     
   • Width:
     
   • Height:
     
5. Heater rating:
   • kW:
     
   • V:
     
   • Phase:
     

If kW requirement is unknown answer questions 6 - 12, otherwise skip to question 13.

6. Ambient air temperature:
   Degrees F:

To maintain temperature:

7. Insulation thickness:
   Inches:
8. Insulation type (e.g. fiberglass, etc):
   Type:

To heat up product:

9. Beginning temperature:
   Degrees F:
10. Desired temperature:
    Degrees F:
11. Allowable heat-up time:
    • Hours:
      
    • Minutes:
      
12. Flow rate:
    • Gallons:
      
    • Pounds:
      
    • Rate / Hour(s):
      
    • Rate / Day:
      
13. In-Line Heaters or Heat Transfer Systems describe heat load:
    

Control requirements:

14. Temperature control:
    • Mechanical
    • Solid State
15. Load switching:
    • Magnetic Contactor
    • Mercury Relay
    • SCR
16. Other:
    • Time Clock
    • If other please describe: