PLIDCO®+Flange
Order Information Form
* = required field
Date
Customer
Contact Person
*
Contact Phone
*
Final Product Destination
*
E-mail
*
PLIDCO®+Flange Size
Pipe O.D.
*
Wall Thickness
Working Pressure
*
Material
Max Design Pressure
*
Temperature
*
Pipe Content
*
Packing Type
Unanchored Pressure
Anchored Pressure
Flange Type
ANSI
MSS-SP44
API
Other
Flange Face Type
RF
FF
RTJ
LJ
Other
Pressure Class
150#
300#
400#
600#
Other
Application:
Weld
Non-Weld
Underwater Usage?
Depth
Installation:
Vertical
Horizontal
External Forces?
Type and Magnitude
Vents Required (Size/#)
Sealant Type
Provided Volume Required
Anode Required
Plated Studs & Nuts
White Marine Epoxy
Flange Gasket
Extra Clamp Screws
Extra Thrust Screws
Extra Packing
Lifting Eyes
Special Screw Material Required
Special Body Material Required
Material Certs Required
Special Tests Required
Quantity Required
Delivery:
Standard
PPT
Remarks
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