Level Application Information *indicates required information
Company Name:Contact Name:*
Address 1:Phone #:
Address 2:Fax #:
Email:*
General
Application
Statement:
Product Information
Product to be Measured: MIN/MAX Di-electric:  
Material Composition:      Process Compatibility with what Material?         
Material Coating in Vessel? Composition: Thickness:

Surface Appearance:

Foam? Yes: No: Height: Inches: Millimeters: Density:

Floating Solids? Type: Spraying? Boiling?:

Measurement Range Units Process Range
(from tank bottom) (MIN) (NOM) (MAX)   (MIN) (MAX)
Material Level:
Material Pressure:
Material Temperature:
Level Conditions:
Instrument Connections
37 Degree Flare Tube   Wafer   MNPT Threads; Size  
Flanged; Flange Rating:   ANSI   DIN   Other  
 
Acceptable Wetted Material:
Corrosion/Erosion Effect:
Maximum Allowable Space from top of tank to highest level:

Accuracy Required when Stationary (still): 

IN MM
% of Span
Accuracy Required when Moving (agitated): IN MM % of Span
Function:
Control:     Indication:     Alarm:    Data Log:  
Power Available:
VDC: Two Wire: VAC: Hz:
Type of Measurement:
Continuous (transmitter):     Point (switch):    
System Output Signal:
VDC: mADC: Digital: Relay

Characteristics

System Display:
None:     Setup Meter:     Indicating Meter:    
Digital, 3 1/2 Digits:     Other No. of Digits Local:     Remote:    

Electronic Sensor Separation: Ft: Inches

Housings:
Controller:
Std:     Nema 4:     Nema 4x:  

CL1 DIV 1:     CL1 DIV 2:     CL 2 Div 1:    Cl 2 Div 2:    

Instrinsically Safe:    

Electronics:
Std:   Nema 4:     Nema 4x:    

CL1 DIV 1:     CL1 DIV 2:     CL 2 Div 1:    Cl 2 Div 2:    


Mounting:
Wall Mounted:     Rack Mounted:     Panel Mounted:    
Ambient Temperature:     Celcius   Fahrenheight
Special Quoting Conditions:
 		Miscellaneous Details:
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