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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:

Pallet Data
Length of Pallet =
Width of Pallet =
Thickness of Pallet =
Height with Fixtures =
Maximum Height with Product =
Pallet Material =
Weight Empty =
Maximum Loaded Weight =
Product =
Will Product Overhang ? Yes No
If "YES", By How Much ? W x L
Pallet Speed = (fpm)
Line Elevation(s) = (inches)
System Configuration =
Note: You may fax a sketch or drawing of System Configuration to us at: (574) 935-4581, or E-mail it to engineering@itequipment.com

Will Pallets Have Cutouts in Their Leading and Trailing Edges for Insertion of Pallet Stops ? Yes No
Will Process Line Be Filled with Pallets, Or How Many On Line ?
Will Empty Line Be Filled with Pallets, Or How Many Will Be On the Line ?

Conveyor Location Conditions
Will Conveyor Be Exposed To:
High Ambient Temperatures ? Yes No
If "YES", Temperature = Deg. (F)
Oily Conditions ? Yes No
Dust ? Yes No
Other Contaminants ?

Service Requirements
Electrical = Volt
Phase
Hertz
Air Pressure Available ? (PSI)
Operation Time ? Days per Week Hours per Day

Conveyor System Preference
Frame = Aluminum Steel
Supporting Chain Rollers = Plastic Steel
Conveyor Series Preference ?
Click Here for Transpoter Selection Chart

Stop Preference
Hard Side Stops (Adjecent to Receiving Transfers) ?
Hard End Stops (End of Line) ?
Cushioned Stop Series (Queue) ?
Cushioned Stop Series (Station) ?
Click Here for Cushion Stop Selection Chart



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