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APPENDIX c
Air &
Multipurpose
General Purpose
Heavy Duty
Push-on
Chemical
Transfer
Cleaning
Equipment
Food
Transfer
Washdown
Marine
Material
Handling
Abrasives
Bulk Transfer
Cement & Concrete
Mining
Petroleum
Aircraft Fueling
Dispensing
Dock
Transfer
Spray
Steam
Vacuum
Veyance
Water
Discharge
Suction &
Discharge
Washdown
Welding
Coupling
Systems
APPENDIX
313
SIZE:
I.D.
O.D.
Hose Length (OAL or uncoupled length)
Tolerances
TEMPERATURE:
of Material Bein
g Conveyed (High, Low, Ambient)
of Outside E
xposure (High, Low, Ambient)
Intermittent?
Constant?
Sub-zero Exposure?
APP
LICATION(S):
Indoor and/o
r Outdoor Use
Intermittent or Cont
inuous Use
Flexibility Required (Min. Bend
Radius)
Movement (Static, Vibrations, Fle
xing)
External Conditions: Abrasio
n
Oil
Solvents
Acid
Ozone
Electrical/Static Conductive
Oil Resistance: Tube
Cover
Flame Resistance
Non-contaminating Materials
Hose Currently in Use
Current Hose Service Life/Failure Description
Service Life Desired
MATERIAL(S) BEING CONVEYED:
Solids (Size, Description)
Gaseous (Volatility, Inert)
Liquids (Flammability, Causticity, Acid/Alkaline,
Solution/Concentration)
Chemical Names (Generic)
PRESSURE(S):
Working Pressure (Including Surges)
Burst Pressure
Suction or Vacuum Requirements
Velocity
Impulse
ENDS & FITTINGS:
Factory Applied Fittings:
Type of threads
Male/Female
Reusable/Nonreusable
Material for Fittings
Built-in Fittings / Ends:
Beaded
Flanged
Rubber-Lined
Other
Cut to Length
Crimp Specs/Crimper (Hydraulics)
DELIVERY:
Lead time
Quantity
Stock/Nonstock
Special Print
Special Packaging
OTHER INFORMATION:
Cu
stomer: Date:
Custom
er #:
Ship To:
Bill To:
Telephone #:
Fax#:
Bolded block areas
MUST be filled out on all inquiries.
INDUSTRIAL HOSE INQUIRY/RECOMMENDATION
GENERAL INFORMATION
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