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Company / Name
Company / Name
Address
*
Phone number
*
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Order Type
Single Impeller
Complete Mixer
Complete Mixing Tank
Other
More Details
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Impeller Type
Marine Propeller
Rushton Disk
Ribbon
Turbine
Paddle
Other
More Details
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Fluid Data
1) Name/Ratio/Density/Viscosity
2) Name/Ratio/Density/Viscosity
3) Name/Ratio/Density/Viscosity
Final Mixture Density/ Viscosity
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Solids
Soluble
Insoluble
Abrasive
Sticky
Crystalline
Fluffy
Other
More Details
Solid Content (kg/lit)
Solid Density (kg/m3)
Solid Particles Size (micrometer)
Suspension Density (kg/m3)
Particles Settling Velocity (m/s)
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Tropicalisation/Winterization
Trop. Required
Win. Required
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Electrical Area Classification
Hazardous Area
Safe Area
Zone
Group
Temperature Class
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Site Data
Elevation [MSL] (m)
Barometric Pressure (mmHg)
Amb. Temperature (C) [min/max]
Relative Humidity (%) [min/max]
Unusual Conditions
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Cooling Water
Temperature (C) [Inlet/Return]
Pressure (barg) [Inlet/Return]
Chlorine Concentration (ppm)
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Inst. Air Press. (barg) [min/max]
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Steam Temp. (C) [min/max]
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Steam Press. (barg) [min/max]
******************************************
Agitation Class
Blending
Dissolving
Suspending Solids
Emulsifying
Heat Transfer
Gas Dispersion
Two Phase Reaction
Three Phase Reaction
Other
More Details
Time Required for Agitation (min)
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Mixing Type
Mild
Medium
Violent
Other
More Details
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Foam
NA
Slight
Average
Bad
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Cycle
Batch
Continuous
Min Batch Volume (lit)
Normal Batch Volume (lit)
Max Batch Volume (lit)
Continuous Flow Rate (lit/hr)
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Mixer Will Not Operate
During Filling
During Discharge
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Mixer Will Operate
During Filling
During Discharge
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Material of Construction
Vessel
Shaft
Impeller
Mating Flanges
Stuffing Box
Steady Bearings
Packing
Other Wetted Parts
******************************************
Selection
Serial Number
Req'd Vessel Opening Size (mm)
Pressure Class
Facing
Mixer Location on Vessel
Mixer Angle / Related to
Other (Specify)
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Impeller
Diameter (mm)
Number
Speed (rpm)
Required BHP (kW)
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Bearings
Steady Bearing
Required
Type
More Details
Guide Bearing
Required
Type
More Details
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Shaft Seal
Mechanism
Packing
Mechanical Seal
Make
Type
******************************************
Shaft Coupling
Make
Type
Speed Reduction
Required
Not Required
Speed Reduction Mechanism
Belt
Gear
Other
More Details
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Gear Data
Manufacturer
Size
Reduction Ratio
Rated Power (kW)
Max BHP (kW)
Mechanical Efficiency (%)
No. Reductions
Output (rpm)
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Electromotor Data
Manufacturer
Type
Speed (rpm)
Electrical Power (kW)
Volts/ Hertz/ Phase
Service Factor
Frame
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Test
Dimensional Check
Not Required
Required
UT (Internal Surface)
Not Required
Required
PT (External Surface)
Not Required
Required
Mechanical Run
Not Required
Required
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Finishing
Not Required
Mechanical Polish
Mechanical & Electo Polish
Other
More Details
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Revision
Z
A
B
C
Other
More Details
Date
Prepared By
Checked By
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