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AZCUE PUMPS USA, INC.

Company Name: ___________________________________ Date: _________


Address: ___________________________________
Contact: ___________________________________
Alternate contact: ___________________________________
E-mail: ___________________________________
Telephone no: ___________________________________
Fax no: ___________________________________

Your Ref No: ___________________________________

WHEN INQUIRING please provide the following information to enable us to select the right pump:

Qty required: _________

Orientation: _________ Vertical or Horizontal

Pump Type: _________

Self Primed / Priming _________

Required capacity (Q) _________ M3/HR

Required manometric head (H). _________ meters

NPSH required _________ meters

Desired speed (RPM) _________ rpm

Whether the liquids are corrosive __________

Type of driving unit preferred (motor) __________ ( diesel, electric, pneumatic or hydraulic)

Chemical or commercial designation of fluid __________ ( potable water, chlorine, salt water, fresh
water, oil, Grey water, fire fighting, cooling,
air conditioning, refrigeration etc… )

Electrical supply available (P) * __________ ( voltage and cycles, KW / Phase )

Maximum viscosity at which you expect the liquids to be pumped __________________

Your recommendations, if any, regarding materials of construction __________________

Other comments/ suggestion: ___________________________________________

10308 W McNab Road, Tamarac, FL 33321


Phone: (954) 597-7602 Ô Fax (954) 597-7608
E-mail: azcuepumps@aol.com
Web Site: www.azcuepumpsusa.com

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