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Product Request Form

In case that you need us to help you with choosing the right product, please fill out this form 

• For your own benefit, please complete the following form carefully and submit to our sales department.Feel free to contact us if you have any question.

Name*

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Prefix

First Name

Last Name

Country*

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State*

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City*

City

Zip Code*

Phone#*

Fax#

Email address*

Confirm Email address*

Required Head (feet or meters)*

Required Head (feet or meters)

Flow Head (Lit/min – m3/h – G/min)*

Flow Head (Lit/min – m3/h – G/min)

Installation Method*

Outdoor Area

Indoor Area

Submerge

In-line

Install in well

Installation Method

Phase*

Single Phase

Three Phase

Other Special conditions

Voltage (V)*

Frequency (Hz)

How does the pump operating?*

Part-time (Less than 2 hours)

Continuously (More than 2 hours non-stop)

What is the pump used for?*

Is the fluid containing certain solids? (Explain)*

Available Protection System (Control Panel)*

Fluid Name*

Fluid PH

Fluid Temperature (°C – °F)*

Need any specific standard? (If yes please notify)

Fluid Viscosity

Fluid density (kg/cm2)

Ambient Temperature (°C – °F)

Suction Head

Fluid Combustion Degree (°C – °F)

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IMPORTANT NOTICE: Pump supermarket can help their customers to choose the most suitable pump for a specific matter. If you need our opinion, please fill out this form carefully and send for us. Otherwise, you may consult with your preferred engineer, before choosing any of our products. Pumpsupermarket.com declines any responsibility about this guidance.