Company Name

Job Name

Contact Name (First & Last)

Phone

Email

Fax Number

Elevator

Jack Quantity

Piston Stages Quantity

Piston OD(S)

Capacity

Floor Rise

Car Speed

Empty Car Static Pressure

Empty Car Weight

Existing Motor HP

Line Voltage

Starts / HR

Existing Valve Model

Valve Coil Voltage

Tank Outlet Side

Low Oil SwitchPressure GaugeLow Pressure SwitchOil Cooler Ports (2-3/4' NPT)Pipe Rupture Valve

Tank Heater
Auto 100ºAdjustable ThermostaticNone

Shut Off Ball Valve
NPTGrooveNone

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