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Customer Information Company Name: Submitted By: Address: Title: City, State, Zip: Phone Number: Country: Fax Number: I.T. Equipment Sales Rep.: E-mail Address: Specifications Choose Type = MINI-Beltveyor BIG-MINI MINI-Elevayor BIG-MINI Elevayor ROLLDRIVE-BELTVEYOR Drive Arrangement = Drive Package Location from Discharge End (If Center Driven)= Select Drive = 1/60/115 Volt 1/8 H.P. 1/3 H.P., D.P. 1/3 H.P., T. Encl. 3/60/230-460 Volt 1/3 H.P., D.P. 1/3 H.P., T. Encl. D.C., 1/60/115 Volt 1/8 H.P., D.P. 1/3 H.P., T. Encl. "T" Dimension = Overall Length = MINI Construction ? Troughed (W/Raised Sides) = Yes No MICRO Construction ?(Without Raised Sides) = Yes No Flared Sides ? Yes No Removable Sides ? Yes No Other ? Belt Type = Cleat Height = @centers Angle of Incline = Deg. Belt Splice = Laced Endless Belt Speed = F.P.M. Supports = Infeed Height Discharge Height HS- (Type) Number: BMS- (Type) Number: Construction = Standard Steel Stainless Steel Paint = I.T.E. Green I.T.E. Gray Special Color (Chip or Spec.) Application Information Material Handled = Size = Weight = (Unit and Per Foot of Conveyor) Product Temperature = Deg. (F) How Will it be Conveyed ? Packaged Loose Other Details =

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