To/From
Company		Phone
Contact		Fax
Reference No.		Email

Type of plant		Place
Item No.		Designation
Qty. of pumps		Requirements
Running/stand-by

Scope of supply		bare shaft pump		coupling		coupling guard
		complete unit		motor		base plate

Liquid data
Liquid to be pumped		kin. viscosity at tA	mm²/s
Solids content	Ma%	Steam pressure (abs) at tA	bar
corrosive ingredients		pH-value at tA
erosive ingredients		Flash point	°C
Oper. temperature tA	°C	Pour point	°C
Density at tA	kg/m³	Danger class acc. to VbF

Operating conditions
	Design point	max	min
Flow rate				m³/h
Inlet pressure				bar
Discharge pressure				bar
Differential pressure				bar
Head				mFI
NPSH of system				m
Speed				min-1

Pump version / Operating conditions
Pump type				design		horizontal		vertical
Number of stages
self-priming
Kind of installation	dry	wet	Installation depth / Immersion depth:
Place of installation	outdoor	indoor	Operation			continuous		intermittent

	Rated dia.	Rated pressure	Flange type	Branch position
Suction branch
Discharge branch
vent
drain

	Casing		Impeller		Diffuser
	Shaft		Shaft sleeve		Base plate

Shaft seal
	Gland packing			single			double
	Mechanical seal			single acting			double acting
	Magnetic drive
	Brand			Type
	Мaterial
Coupling
	Brand			Type
	Spacer			with			without

Motor
Brand		Type
Design version		Rated speed	min-1
Voltage	V	Frequency	Hz
Protection		Explosion protection
Certificates/Tests/Special versions

Tests
	Materials	Pressure	Capacity	NPSH		Inspection	Final Inspection
acc. to
executed by
Documentation
Performance	Offer			Dim. Drwg
curve	Test			Piping	Shaft sealing
Operating instructions					Auxilliary Systems
Spare parts list				Installation drawings	Pump
Accessories/Remarks/Miscellaneous					Shaft seal ring