Quote Form: Header/Hub Laterals

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Date

MM slash DD slash YYYY

Contact Information

Customer Name

First Last

Project Name

Company Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email

Application Data

Item 1. Lateral overall length:

Unit of measure:

Inches

Millimeters

Qty:

Item 2. Lateral overall length:

Unit of measure:

Inches

Millimeters

Qty:

Item 3. Lateral overall length:

Unit of measure:

Inches

Millimeters

Qty:

Untitled

Distributor

Collector

End connection type:

Material:

Other Material

Desired particle retention size:

Mesh

Micron

MM

µm

Incoming pipe size:

Unit of measure:

inches

mm

Outgoing pipe size:

Unit of measure:

inches

mm

Outgoing configuration:

Side

Bottom

Collection flow volume:

Unit of measure:

USgpm

L/s

Backwash flow volume:

Unit of measure:

USgpm

L/s

Allowable pressure loss (excluding header)

Unit of measure:

kPa

PSI

Notes / Comments

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