Tyco Flow Control Pacific

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Hose Enquiry Form

TFCP - Industrial

Hose Enquiry Form

Please read the Information Collection Statement prior to completing any form

Hose Enquiry Form

Company :

Date :

Person to contact :

Department :

E-mail address :
(essential field)

Telephone :

Facsimile :

It is essential to fill in the bold-framed part below :

Nominal Diameter /ND :
mm

Total Length (measured overall)
mm

Actual existing service pressure :

Internal (Bar):

External (Bar):

Bend radius mm:

Quantity :

End fittings - First End :

End fittings - Second End :

Medium to be conveyed :

Service temperature °C :

Termperature of the surroundings °C:

Please fill in as far as possible

Material of the hose :

Material of the braiding :

Material of the end fittings :

Deflective Stress

Small, slow movement

	yes
	no

Uniform Movement Rhythmic continuous movement

	yes
	no

Without Vibration

	yes
	no

Little Vibration

	yes
	no

Strong Vibration

	yes
	no

Frequency of motions
strokes / h

Steady or slow, uniform flow

	yes
	no

Pulsating / dynamic flow

	yes
	no

Rhythmic/intermittent flow

Flow velocity
m/s

Flow rate
m3/h

Outside effects :

Installation/Use :

Special requirments :