PLIDCO® Split+Repair Ell
Order Information Form
* = required field
Date
Customer
Contact Person
*
Contact Phone
*
Final Product Destination
*
E-mail
*
Pipe O.D.
*
Split+Repair Ell Size
Wall Thickness
Working Pressure
*
Material
Max Design Pressure
*
Temperature
*
Pipe Content
*
Packing Type
Ell Type
Butt-weld
Pipe Bend
Screwed
Mitered
Socket-weld
Angle of Ell
45°
90 °
Other
Pressure Class
2000#
3000#
6000#
Other
Application:
Weld
Non-Weld
Rows of Packing:
Single
Double
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
Extra Studs & Nuts
Hinges Required
Clamp Ends
Extra Packing
Vent Covers
Special Materials Required
Material Certs Required
Special Tests Required
Quantity Required
Delivery:
Standard
PPT
Remarks
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