500 VALLEY ROAD, RICHMOND, VA 23222
PHONE: (804) 321-3333  FAX: (804) 329-0112
QUOTATION REQUEST FORM
CUSTOMER INFORMATION
CONTACT NAME:
TITLE:
COMPANY NAME:
ADDRESS:
 
PHONE #:
FAX:
E-MAIL:
DUE DATE:
EQUIP. NAME/#:
 
QUANTITY:
 

MATERIAL INFORMATION
HEADS:
SHELL:
JACKET:
PIPE:
FLANGES:
PAINT:
INTERNALS

SUPPORTS:
OTHER:
 
 
 
 
DESIGN INFORMATION
GENERAL
CODE:
CODE STAMP REQUIRED:
ORIENTATION:   HORIZONTAL       VERTICAL
SUPPORTS:                  TYPE:
    NUMBER:                  HEIGHT:
 
SHELL
DESIGN PRESSURE  INT:                 EXT:
DESIGN TEMP:                     °F                      °C
DIAMETER:               OD/ID LENGTH:
CORROSION ALLOWANCE:
RADIOGRAPHY:       FULL      SPOT      NONE
ADDITIONAL NDE:
MIN. THICKNESS:                   SPEC. GRAV.:
 
JACKET
JACKET TYPE:
DESIGN PRESSURE  INT:              EXT:
DESIGN TEMP:                   °F                     °C
DIAMETER:              OD/ID LENGTH:
CORROSION ALLOWANCE
RADIOGRAPHY:       FULL      SPOT      NONE
ADDITONAL NDE:
MIN. THICKNESS:                   SPEC. GRAV.:
NOZZLE INFOMATION
DESC.
QTY.
SIZE
RATING
TYPE
         
         
         
         
         
         
         
              
              
         
         
         
         
REMARKS/ COMMENTS
 
 
 
 
 
 
 
 
 
 
PLEASE USE ADDITIONAL PAGES FOR ANY FURTHER INFORMATION OR TO ATTACH SKETCH