Quote Form: Header/Hub Laterals

DATE:

CONTACT INFORMATION

Customer Name:

Project Name:

Company Name:

Street Address:

City:

State:

Zip Code:

Province:

Country:

Phone:

E-Mail:

APPLICATION DATA

Item 1. Lateral overall length:

inches:mm:

Qty:

Item 2. Lateral overall length:

inches:mm:

Qty:

Item 3. Lateral overall length:

inches:mm:

Qty:

DistributorCollector

End connection type:

Material:

Other Material:

Desired particle retention size:

mesh

micron

mm

µm

Incoming pipe size:

inchesmm

Outgoing pipe size:

inchesmm

Outgoing configuration:

SideBottom

Collection flow volume:

USgpmL/s

Backwash flow volume:

USgmpL/s

Allowable pressure loss (excluding header)

kPaPSI

NOTES / COMMENTS