NAME:

COMPANY NAME:

EMAIL ADDRESS:

MAX. OPERATING PRESSURE:

DESIRED SET PRESSURE:

REQUIRED CAPACITY:

MAX. OPERATING TEMP.:

VISCOSITY @ RELIEVING TEMP.:

ALLOWABLE BACK PRESSURE: (NOTE: BACK PRESSURE ONLY EFFECTS FLOW RATE)

MOLECULAR WEIGHT:

SPECIFIC GRAVITY:

COMPRESSIBILITY FACTOR (2):

PHASE OF SERVICE:

NAME OF GAS OR FLUID:

NOMINAL PIPE SIZE:

PIPE SCHEDULE:

OUTLET CONNECTION:

INLET CONNECTION:

ANSI RATING:

BODY MATERIAL:

FLANGE MATERIAL:

EJECTOR MATERIAL:

SEAL MATERIAL:

SPRING MATERIAL:

SPECIAL TAPS REQUIRED:

SPECIAL PAINT OR COATING: