Application Information Form Flow

Date: _______________________________________________________________________________________________

Author Name: ________________________________________________________________________________________

Company/Territory: ___________________________________________________________________________________________

Company:______________________________________
Site Name:_____________________________________
City, State, ZIP:__________________________________
Contact Name:__________________________________
Title:__________________________________________
Phone:_____________________________________
Email:______________________________________
Fax._______________________________________

FLOW APPLICATION INFO: Flow Application Details:

Fluid to be Measured: _________________________________ ___ Liquid ___ Gas ___ Steam ___ Saturated ___ Superheated

Flow rate: Minimum ___________ Maximum________ Nominal___________ ___GPM ___ LB/HR ___ SCFM ___ Other ____

Temperatures: Minimum________ Maximum________ Nominal________ ___C ___ F

Pressures: Minimum___________ Maximum________ Nominal________ ___ psig ___ psia Other ________________________

Density: Minimum_____________ Maximum________ Nominal________ ___ gm/c3 ___ S.G Other ______________________

Viscosity: Minimum____________ Maximum________ Nominal________ ___Centistokes Other ________________________

Conductivity (required for Mag Flow): ___________ Mhos ___ Other ______________________________________________

Flow Conditions: ___ Continuous Flow ___ Pulsating Flow Describe: ________________________________________________
Product
Air/Solids Percentage (%)Requirements
by Volume: _________ Solids: Particle size: _________ Abrasiveness: ___Low ___ Medium ___High

Piping - Straight Runs (not reqd for Coriolis mass flow, VA): Upstream ________Diameters Downstream __________Diameters

Upstream configuration (i.e. elbow, tees, valves, etc.): ________________________________________ (provide detailed sketch)

Flow orientation: ___Up ___Horizontal ___Down Other: ________________________________________________________

End connections: ______# ANSI Flange Sanitary ______________________ Threaded____ inch NPT Other: __________

Nominal pipe size: ______________________ Schedule: _________________ Lined Pipe ___Yes ___ No

Simn Bolivar No. 1918 Col. Mitras Centro Monterrey N.L . 64460 www.drachen.com.mx
info@drachen.com.mx
Product Requirements:
Accuracy requested: ________ % of rate Acceptable wetted materials of construction: ________________________________

Power: ___24VDC ___24VDC Loop Power ___120VAC Other: _______________________________________________

Signal Output: ___ mA ___ Frequency Pulse Other __________________ Output(s) Range(s): _______________________

Communications Protocol: ___ None ___HART ___ Foundation Fieldbus ___Modbus ___ Profibus DP ___ Profibus PA Other
_____________

Hazardous area: ___ No ___Yes ___FM/cFMus ___CSA/cFMus/FMc ___Class _______Division _______ Other __________

Custody Transfer: ___None ___ Mi 005 ___ Mi 002 ___NTEP ___ Measurement Canada ___OIML R117-1 ___ Other ________

Concentration Measurement ( Coriolis Mass Flow Only) :___ None ___API ___Net Oil/Watercut ___Brix___ Baume 144.3
___Baume 145___ General ___NAOH ___Plato ___Alcohol ___Other ____________________________________

Converter Style: ___Compact___ Remote Remote cable length required: ______________ feet meters

Requested Technology: ____Electromagnetic ____ Mass ____Ultrasonic ____VA _____Vortex Other: _________________

Application Status: ____:Operating ____ currently using: ______________________________________ New Application

SKETCH:

Simn Bolivar No. 1918 Col. Mitras Centro Monterrey N.L . 64460 www.drachen.com.mx
info@drachen.com.mx