Quote Request Form

In order to make sure the correct information is submitted, please fill out the form for each TYPE of valve at a time. You will have the option to add another type of valve to this request at the end of the form. Thanks!

Preferred Delivery Date

- Month - Day Year

Quanity*

Valve Type*

Other

Geothermal Application?*

Yes No

Size*

Pressure Class*

End Connection

RF RTJ WE Pipe Schedule

Trim Requirements

Standard Low Temp Geothermal CS x ENP CS x SS SS x SS Duplex Other

NACE?

Yes No

Actuation Requirement

HW BGO Lever Electric Pneumatic Hydraulic

Supply Pressure

Electical Supply

110v 220v 460v 3PH 1PH 60Hz 50Hz

Additional Notes

Would you like to add another type of valve to this order?*

Yes No

Contact Information

Preferred Delivery Date

General Valve Information for Item #1

End Connection and Trim Requirements

Actuation and Supply Requirements

General Valve Information for Item #2

End Connection and Trim Requirements

Actuation and Supply Requirements