Application Questionnaire

REFERENCE INFORMATION
CUSTOMER/COMPANY CITY, STATE, COUNTRY CONTACT/TITLE SIGNATURE PHONE RFQ NUMBER SUBMITTED BY REP AGENCY AND SALESPERSON FAX P. O. NUMBER EMAIL TAG NUMBER REP CODE DATE APPLICATION SAME AS PREVIOUS ORDER # ___________________________________

APPLICATION DATA
APPLICATION PRODUCT NAME BULK DENSITY PROCESS TEMPERATURE PROCESS PRESSURE ANGLE OF REPOSE INDUSTRY

lb/ft3 g/cc Other Ambient Atmosphere min. min. max. max. F

degrees Other

PSIG bar kPa Other

VESSEL DETAILS
VESSEL DESCRIPTION VESSEL TOP SHAPE VESSEL DIMENSIONS (SKETCH ON BACK) VESSEL CENTER SHAPE QUANTITY OF VESSELS TO BE MONITORED POTENTIAL NUMBER OF ADDITIONAL VESSELS TO BE MONITORED VESSEL BOTTOM SHAPE

If Rectangular: Length: Height:

Width:

Height: feet meters

feet

meters

If Round: Diameter:
INTERNAL STRUCTURE MAXIMUM MATERIAL LEVEL

INTERNAL MOVEMENT

Yes No Describe: feet meters

FILLING LOCATION (SKETCH ON BACK)

FILLING METHOD

NOTE: CONTOUR is a 24 VDC line-powered transmitter. Belden #3105A (or equivalent) multi-conductor cable is recommended for the RS-485 wiring. OTHER DATA
DESIRED CONTOUR TYPE

AGENCY APPROVALS REQUIRED

(Basic)

3DSS

(Mapping) (Visualization)

3DSM

3DSV

OUTPUTS USE FOR:

Inventory
HAZARDOUS AREA LOCATION

Process Control

Both

None FM cFM ATEX NEPSI

PREVIOUS TECHNOLOGIES USED

Class: Division: Groups:

5300 Belmont Road Downers Grove, Illinois 60515-4499 630-969-4000 Fax 630-969-9489 www.magnetrol.com

BULLETIN: 61-340.2 EFFECTIVE: May 2013 SUPERSEDES: March 2013

A VESSEL TOP B.
SHAPE

VESSEL TOP
WIDTH HEIGHT

A C D.
VESSEL CENTER

VESSEL CENTER
SHAPE WIDTH HEIGHT

C VESSEL BOTTOM
SHAPE WIDTH

F.

VESSEL BOTTOM

HEIGHT

+y
FILL LOCATION(s) TOP VIEW
DISTANCE FROM CENTER (0,0) TO FILL LOCATION (0,0)

enter x and y values

-x

+x

AVAILABLE MOUNTING LOCATION

DISTANCE FROM CENTER (0,0) TO PROPOSED CONTOUR LOCATION

enter x and y values

-y

PROVIDE SKETCH OF VESSEL INCLUDING FILL AND EMPTY LOCATIONS (Optional) COMMENTS