PEBCO/ CLEVELAND ARMSTRONG
225 North 4th Street P.O. Box 7506 Paducah, KY 42002-7506
Phone # (270) 442-1996 Fax # (270) 442-5214
GATE APPLICATION DATA FORM

DATE		PEBCO FILE CA#
COMPANY:
CONTACT:
ADDRESS:
CITY:	STATE:		ZIP:	COUNTRY:
SHIP TO:
END USER:		REFERENCE TAG#:
REP CO.:		SALESPERSON:
PHONE#:		FAX#:
E-MAIL:

MATERIAL PHYSICAL PROPERTIES

MATERIAL:

PRODUCT TEMP (F):

AMBIENT TEMP (F):

ABRASIVENESS:
VERY
MOD
MILD
NOT

FLOWABILITY:
GOOD
POOR
PACKS
BRIDGES

CORROSIVENESS:
VERY
MOD
MILD
NOT

BULK DENSITY:

PARTICLE SIZE RANGE:

MOISTURE %:

FLOW RATE:

OPERATION PARAMETERS:

GATE FUNCTION:
EQUIPMENT ABOVE GATE:		PRESS/VAC ABOVE GATE:
EQUIPMENT BELOW GATE:		PRESS/VAC BELOW GATE:
OVERALL HEIGHT AVAILABLE:		HEAD OF MATERIAL ABOVE GATE:
MATERIAL FLOW:	VERT. HORT. ANGLE FROM VERT:
DUST ENCLOSURE TYPE:		CUT STANDING COLUMN OF MATERIAL:
DIVERTER CONFIGURATION:	OFFSET ANGLE: INCL. ANGLE:

GATE CONSTRUCTION:

GATE DESCRIPTION/MODEL#:
QUANTITY:		SEALS REQ'D	SEAL TYPE:
MATERIAL OF CONSTRUCTION:
BLADE	FLOW SURF	ALL INTERNALS	COMPLETE
LINERS MATERIAL OF CONSTRUCTION:
BLADE	SEAL RET	FLOW SURF	THICKNESS
NOMINAL INLET SIZE	X		DIRECTION OF BLADE TRAVEL

ACTUATORS:

ACTUATOR TYPE:

PNEU. PRESS:

HYD. PRESS:

HYD. GPM:

SPECIAL ACT.

ACT. MFG.

CLASS

DIVISION:

GROUP:

SPEED OF ACT.

FREQ. OF USE(# of act/unit of time)

VOLTS/PH/HZ:

CONTROL VALVE(S):
QTY
1 COIL/2 POS
2COIL/2POS
2 COIL/3 POS
NEMA

LIMIT SWITCHES:
QTY
SPDT
DPDT
CYLINDER MOUNTED
NEMA

PROXIMITY SWITCHES:
QTY
N.O.
N.C.
CYLINDER MOUNTED
NEMA

FILTER REGULATOR LUBRICATOR SET:

SPECIAL CONSTRUCTION:

SPECIAL PAINT	NON-STANDARD ACTUATOR LOCATION:
STD. PEBCO FLANGE:	APPROVAL DRAWING REQ'D:
DRAWING FORMAT:	FLOPPY DISK:	HARDCOPY:	INTERNET:
(ATTACH ANY SPECIFICATIONS AND/OR NOTE NON-STANDARD ITEMS IN THE COMMENT SECTION BELOW) COMMENTS OR ADDITIONAL SPECIFICATIONS:

P.O. #:

P.O. DATE:

SHIPMENT REQUESTED:

Customer Signature:

Customer Date:

PEBCO^® and Cleveland Armstrong^® are registered trademarks and use is prohibited by law.

PEBCO^®
225 North 4th Street
P.O. Box 7506
Paducah, KY 42002-7506
Tel: (270) 442-1996
Fax: (270) 442-5214
Email: sales@pebco.com