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Gasket Application Data Form Date____________________________________ From ___________________________________ For: Garlock Gasketing Engineering Title ____________________________________ Fax 315-597-3290 Company________________________________ Page: 1 of _______________________________ Address _________________________________ Drawing attached Yes No City / State / Zip___________________________ Phone __________________________________ Fax ____________________________________ E-mail __________________________________ Application Pipe Flange Pumps � centrifugal / horizontal split case Heat Exchanger Flue Duct Manway Valve Bonnet Compressor Other ________________________________ ServiceConditions Maximum Temperature ________________ �F/ �C Continuous Operating Temperature ______ �F/ �C Internal Pressure ___________________psig / bar PSIG / bar Continuous Intermittent Thermal Cycling___________________/ 24 hours Vibration Yes No Other (specify) _______________________________________________________________________ Bolts Grade___________________________________ Diameter ________________________________ Length __________________________________ Number _________________________________ ChemicalCompatibility Media___________________________________ pH _____________________________________ Concentration ____________________________ Liquid or Gas_____________________________ Flange Standard Non-Standard Material _________________________________ Material _________________________________ Size ______________ Rating _____________ I.D. / O.D. ________________________________ Surface Finish ________________________RMS Flange Thickness _________________________ Phonographic Concentric Bolt Circle Diameter _______________________ Face (raised, flat, tongue & groove, etc.) _______ Surface Finish ________________________ RMS ________________________________________ Phonographic Concentric Face (raised, flat, tongue & groove, etc.) _______ _______________________________________ Comments: _________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ Questions?Call C-58
Goodyear Rubber Products
