CONTACT INFORMATION

Name

Company:

Address:

City:

State:

Zip:

Country:

Telephone:

Extension:

Fax:

Cell:

Email:

Position:

How did you hear of Weldon Pump:

APPLICATION INFORMATION

If used on general aviation aircraft, please list:

Make

Model

Description of installation:

Power Plant Description:

If not used on GA aircraft, please describe application and installation:

FLOW INFORMATION

What is the minimum (min) volume (in GPM/GPH) of fluid the pump will pass while operating?

What is the maximum (max) volume (in GPM/GPH) of fluid the pump will pass while operating?

BYPASS VALVE

Will the pump require a bypass valve? (Will fluid need to flow through the pump while not in operation?)

Yes No

RELIEF VALVE

Will the pump require an internal pressure relief valve?

Yes No

   If so, please check the appropriate box below:

           The valve be used solely as a safety provision to prevent over pressurization of the system.

           The valve be the primary device used to regulate system pressure.

PRESSURE

What is the minimum (min) operating pressure of the system?

What is the normal operating pressure of the system?

What is the maximum (max) operating pressure of the system?

Is there a need to reference boost with the valve?

Yes No

FLUID

What fluid(s) is/are being pumped

Fluid Temp range (F):

IF PUMP IS TO BE FURNISHED WITH ELECTRIC MOTOR:

AC Volts   Phase Cycles

DC Volts   Phase Cycles

Commercial | Mil Spec

Open Ventilation | Totally Enclosed | Explosion Resistant

DUTY CYCLE

Continuous Hours per day

Intermittent Minutes On Minutes Off

Ambient Temperature °F  High Temp. °F  Low Temp. °F

Are EMI reducing provisions required for the motor?

What is the maximum altitude of the application?

INLET CONDITIONS

Fluid Head: Positive Negative

Feet of fluid being pumped:

Inlet Pressure: psia   psig

Inlet Line ID:   Length:

Preferred Type of Ports:

Location of Ports: Opposed   Parallel

SPECIAL ENVIRONMENTAL CONSIDERATIONS

TIME FRAME

Information needed:

Date needed:

Projected Annual Usage:

Present need is for:

Prototype

Production

Other

OTHER CONSIDERATIONS