Product Identification

For Office Use Only Project# ______________ Date: ________________ Initials: _______________
Customer Information
Dist/Agent
Customer*
Email*
Contact*
Street Address*
Street Address City State ZIP Code
Phone
Fax
Project Description
Qty/Year
Target Price
General Specifications
Valve Type
Default State
Actuation Method
Schematic/function diagram required
- Yes
- No
Material
Surface Protection
Ambient Temperature
Storage Temperature
Envelope Dim.
Weight
Hydraulic Specifications
Fluid Type
Viscosity Range
Fluid Temperature (min)
Fluid Temperature (max)
Operation Pressure (min)
Operation Pressure (max)
Operation Pressure (proof)
Pressure Drop
Pressure Drop at flow
Flow Range (min)
Flow Range max
Leakage (max)
Leakage at pressure
Electrical Specifications
Supply Voltage
Max Current
Protection Class
Wire Interface
Amplifier Controller Electronics
Motion Analysis
Load Type
- resistive
- overunning
- inertial
- static
Applied Loads (lbs or in-lbs)
Applied Loads (Newtons or radians)
Max Acceleration (in/sec/sec or mm/sec/sec)
Frequency Response (HZ or Rad/sec)
Terminal Velocity (inches/sec or mm/sec)
Accuracy (inches) or mm)
Accuracy (degress or radians)
Actuator Specifications
Piston Diameter
Rod Diameter
Working Stroke (inch/mm)
Motor Disp c.i.r/ml.r
Moment of Inertia
Calculations/Simulation Required
- Yes
- No
Additional Notes
Approved for Development: Date:________ Mgmt. Initials: _____

Customer Information