Please print out this sheet and send by fax to +81-3-5442-6914

Gear Pump Inquiries
To: Daito Kogyo Co Ltd
C/o: ISS Machinery Services Limited, Japan (Fax: 81-3-5442-6914)
  Date/ Month/ Year
From:
Your Company Name :                  .
Address:
Contact Person :
Your Tel :_______________________________________ Your FAX                     .
User Name Delivery Place 
Delivery Time Quantity 
Name of Pump Item No. 
LiquidName of Fluid Temperature
Viscositymm2/S
mPa.S
Spec.gr. 
Feature Solid  Yes / No
Pump Specification Capacity    l/min       KL/HSuction PressureMPa
Suction
Condition
NPSHa   m      TorrDischarge PressureMPa
Construction
Lining FC. FCD. SC. SUS304. SUS316. ALBC2. other
Shaft Seal  Gland Packing/ Mech Seal/ Oil Seal/ Non-Seal
Jacket without ・ with (Casing/ Shaft Seal/ Cover/ All)
Safety Valve  Built In (Yes / No) Independent (Yes/ No)
MotorType  TEFC/ ExdIIBT4/ ExeIIT3/ Indoor/ Outdoor
Power     φ      V      Hz
Other Driver 
Spare parts 
Remarks
(Budget?)