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