Information Request Form

Please use this form to request a quote, or information about our products.

Company:   Date:
Attention: Phone:
Address: Fax:
e-mail:
Literature:

** Required Information is noted in RED**

OPERATING CONDITIONS
AND PREFORMANCE

 INQUIRY NO.
      SERVICE  
LIQUID
 TEMP. °F
 SP.GR @temp.

CONSTRUCTION DETAILS
GPM
 T.D.H.
 V.P.
 VISC.
 QUANTITY
 MODEL
 SIZE
 ROTATION
EFF.
 RATED B.H.P.
 MAX. B.H.P.
 SUCT. PRESS.
 CASING
 IMPELLER
 SHAFT
 SLEEVE
DISCH. PRESS
   NPSHR
 NPSHA
 WEAR PLATE
 LUBRICATION
 BASE PLATE
 COUPLING
IMPELLER DIAMETER
RATED
 MIN.
 MAX
IMP. TYPE
 BULLETIN
 MECHANICAL SEAL OR PACKING
 FRAME MOUNTED OR CLOSE COUPLED
 
 Note:
We are happy to help determine any required fields, feel free to call 1-800-447-PUMP(7867)
 
DRIVERS
H.P.
 RPM
 ENCLOSURE
 FRAME
 S.F.INSUL.
    
PHASE
 HERTZ
 VOLTAGE
 FURNISHED BY
    
UNIT DESCRIPTION  

SELECTION & PRICING (Please use one text box to enter information for each separate unit)

Pumps& Process Machinery Compressprs, Blowers, Specialties GPM Corporation home page

Contact GPM Corporation via e-mail at info@gpm2.com