Split+Sleeve
Order Information Form
Date
Customer
Contact Person
Contact Phone
E-mail
Sleeve Size
Pipe O.D.
Temperature
Working Pressure
Wall Thickness
Max Design Pressure
Material
Packing Type
Pipe Content
Length Between Seals
Belly Diamater
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
Sling Closures
Extra Packing
Vent Covers
Special Materials Required
Material Certs Required
Special Tests Required
Quantity Required
Delivery:
Standard
PPT
Remarks
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