Chiller Request Form

Your First Name^*

Last Name^*

Company

Email^*

Phone^*

Street Address^*

City^*

Province/State^*

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Country^*

Chiller Application

Liquid to be cooled WaterOther

Quality of Water

Describe Water Quality

What Liquid will be cooled

Liquid Temp (Inlet to Process)

ºFºC

Return Liquid Temp (Outlet from Process)

ºFºC

Process Liquid Flow Rate (US gpm)

Process Liquid Pressure

BarPSI

Process Pressure Drop

BarPSI

Process Connection Size & Type

inchesmm

Material to be Cooled

QTY (lbs/hr)

Specific Gravity of Material

Specific Heat of Material

Viscosity of Material

Centipoiselbs/ft-hr

Condensor Type: Air-cooledWater-cooled

Ambient Temp

ºFºC

Chiller Placement

Distance from Process (ft)

Available Electrical:

Volts

Phase

Hertz

Pumping Stations: YesNo

Describe

Liquid Reservoir: YesNo

Liquid Reservoir Type & Volume

Filtration: YesNo

Suspended Particle Size

inchmm

Liquid Heating: YesNo

Desired Temp (ºF)

Space Limits (inches)

W

D

H

Additional Notes

Chiller Request Form

Step 1: Personal/Company Info

Step 2: Chiller Info

Step 3: Last Step

Quick Links

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