Sampler Application Information *indicates required information
Company Name:Contact Name:*
Address 1:Phone #:
Address 2:Fax #:
Email:*
General
Application
Statement:
Product Information
Product to be Sampled:
Size of Sample Cut:  
Material Composition:

Sample Temp     

Sample Container Size: Elect Power Supply: or Clean, Dry, Oil Free Air Y N Line Pressure

Sampler Location:

Temp Controlled Shelter Y Outdoor : Temp Range in Shelter Cabinet Rating Nema 4 4X

Ambient Temperature Other Stream Info (Particulate etc.): H2S %

Componet MOL %
Minimum
Normal
Maximum
System Output Signal:
VDC: mADC: Digital: Relay:
 
Characteristics
Housings:
Sampler
Std:     Nema 4:     Nema 4x:    
CL 1 DIV 1:     CL 1 DIV 2:     CL 2 DIV 1:     CL 2 DIV 2:      

Instrinsically Safe:    

Controller Mounting:
Wall Mounted:     Rack Mounted:     Panel Mounted: