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

          
            

              
              

                DUSTY: 

              

                VERY 
                
                 

              

                MOD 
                
                 

              

                MILD 
                
                 

              

                NOT 
                
                 

          
            

              
              

                CORROSIVENESS: 

              

                VERY 
                
                 

              

                MOD 
                
                 

              

                MILD 
                
                 

              

                NOT 
                
                 

    BULK DENSITY: 
     

  

    PARTICLE SIZE 
      RANGE: 
     

  

    MOISTURE %: 
     

  

    FLOW RATE: 
     
    

  

    
      

        
        

          
            

              
              

                TRUCK 

              

                OPEN: 
                
                 

              

                OPEN/CROSS 
                  BRACING: 
                 

              

                ENCLOSED: 
                 

              

                OTHER/SPECIFY: 
                 

          
            

              
              

                RAILCAR 

              

                OPEN: 
                
                 

              

                ENCLOSED: 
                 

              

                CENTER 
                  SLOTTED: 
                 

              

                OTHER/SPECIFY: 
                 


          
            

              
              

                SHIP 

              

                OPEN: 
                
                 

              

                ENCLOSED: 
                 

              

                CENTER 
                  SLOTTED: 
                 

              

                OTHER/SPECIFY: 
                 

          
            

              
              

                OTHER 

              

                OPEN 
                  STACKING: 
                 

              

                STACKING: 
                 

              

                BAG OR 
                  DRUM: 
                 

              

                FILLING: 
                 


  

    1. IS PRODUCT 
      AERATED (INFEED HOPPER BOTTOM OR AIR SLIDE)?  IF SO, SPECIFY 
       

  

    2. ENCLOSURE CONE 
      REQUIRED?  

  

    3. CLEARANCE HEIGHT 
      REQUIRED UNDER SPOUT WHEN RETRACTED:  

  

    4. HOW MUCH VERTICAL 
      TRAVEL IS REQUIRED?  

  

    5. TRIMMER REQ'D: 
       
    DUST COLLECTOR REQ'D:  
    DUST COLLECTOR TYPE? 
      
     

  

    6. DIMENSIONS OF HATCH 
      OPENINGS:  X SQUARE 
    ROUND(DIAMETER) 

  

    7. IS HORIZONTAL SPOUT 
      TRAVEL DESIRED?  HOW HORIZONTAL TRAVEL?  

  

    8. DIMENSIONAL CLEARANCES: 
       



  
  

    OPERATION 
      PARAMETERS: 



  
  

    SPOUT/CHUTE FUNCTION: 
     
    RAISE/LOWER SPEED (FPM) 
    
     

  

    EQUIPMENT ABOVE: 
     

  

    EQUIPMENT BELOW: 
     

  

    FREQ. OF USE: 
     



  
  

    CONSTRUCTION: 



  
  

    PEBCO® MODEL#: 
     
    QTY. 
     
    

  

    CONE/TUB MATERIAL: 
     
    SLEEVE MATERIAL: 
     

  

    STANDARD PEBCO® FLANGE: 
       
    STANDARD PEBCO® PAINT: 
       

  

    
      

        
        

          
            

              
              

                "DRIVE" 
(V/PH/HZ) 		
                NEMA 
                HAZARDOUS AREA CLASSIFICATION 

              

                CLASS 
                
                DIVISION 
                GROUP 
                
              

                 
                 
                 
                 
                 

          
            

              
              

                "CONTROL" 
(V/PH/HZ) 		
                AREA CLASSIFICATION 

              

                CLASS 
                
                DIVISION 
                GROUP 
                
              

                 
                 
                 
                 
        



  
  

    AUTO RAISE REQ'D: 
       
    AUTO LOWER REQ'D: 
       
    LEVEL PROBE REQ'D: 
       
    TYPE:  




  
  

    SLACK CABLE SWITCH(S) REQ'D: 
       
    NO.  
    PRE-WIRE TO BOX W/ 
      TERMINAL STRIP:  
  



  
  

    CONTROL PANEL: 
     
    # PUSHBUTTONS: 
     
    # INDICATOR LIGHTS 
     
    # SELECTOR SWITCH(S) 

     
    NEMA 
     

  

    PENDANT STATION: 
     
    # PUSHBUTTONS: 
     
    # INDICATOR LIGHTS 
     
    # SELECTOR SWITCH(S) 

     
    NEMA 
     



  
  

    (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: 
     



  
  

    APPROVAL DRAWING REQ'D: 
    DRAWING 
      FORMAT: 
    FLOPPY 
      DISK: 
    HARDCOPY: 
    INTERNET: 
  



  
  

    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




© 2002, PEBCO®