System Proposal Request

*Contact Name

*Company Name

*Title

*E-mail

*Phone

Fax

*Address

RFQ#

Date

System Location Air Conditioned Room Indoor Outdoor

Cooling Water Availability:

Pressure

PSIG Temperature

Source

Sample Lines and Analysis Required*

*For analyzers to be shared – mark with "S" and indicate other sample line numbers.

Sample Line Designation

Design Pressure PSG TEMP ° F

Conductivity Specific Cation

pH DO Hydrazine Silica Phosphate

Sodium Other

Sample Line Designation

Design Pressure PSG TEMP ° F

Conductivity Specific Cation

pH DO Hydrazine Silica Phosphate

Sodium Other

Sample Line Designation

Design Pressure PSG TEMP ° F

Conductivity Specific Cation

pH DO Hydrazine Silica Phosphate

Sodium Other

Sample Line Designation

Design Pressure PSG TEMP ° F

Conductivity Specific Cation

pH DO Hydrazine Silica Phosphate

Sodium Other

Customer Preferences

Analyzers:

Conductivity

pH

Dissolved Oxygen

Hydrazine

Phosphate

Silica

Sodium

Other

Recorders Local remote add "R" in appropriate analysis boxes above

Others Preferences

Other Design Considerations

Size of Sample Transfer lines

Blowdown Valves: Choose Lines Requiring Blowdown

Reclaim:

Separate Drains Only

Tank & Pump in Panel

Secondary Temperature Control

Output Signals – External to Panel

Controllers:

Item to be controlled

Input Signal Sources

Output Signal Required

Panel Size Restrictions H x W x L Rear Clearance Available

Notes:

*These fields must be completed before your information can be submitted.