| Company: | Date: |
| Address: | Phone Number: |
| P.O.# | Fax Number: |
| 1) Tag# | |||||
| 2) Element Type: (check one) |
Orifice |
Quadrant Edge | Venturi | ||
| Restriction | Segmental | Flow Nozzle | |||
| Eccentric Bore | Honed Flow Section | Low-Loss Venturi | |||
| 3) Taps (check one) | Flange Taps | Pipe Taps | Corner Taps | ||
| 4) Element Material (check one) | 316 SS | Other - Specify: | |||
| 5) Pipe Material: (check one) | Carbon Steel | Other - Specify: | |||
| 6) Pipe Size = | Line Size = | Line Schedule = | |||
| 7) Fluid State (check one) | Liquid | Gas | Steam % | Super Heat | |
| 8) Name of Fluid = | |||||
| 9) Flowing Upstream Pressure = | Units = | ||||
| 10) Atmospheric Pressure at Site: (check one) | 14.96PSI | Other | |||
| 11) Temperature at Flowing = F | |||||
| 12) Calculate for: (check one) | Orifice Bore | Maximum Flow | Maximum Differential | ||
| 13) Fluid Property (Specify one @ flowing Conditions) |
Specific Gravity = | Density = | Molecular Weight = | ||
| 14) Flowing Viscosity in Centipoise | Viscosity = | ||||
| 15) Cp /Cv gas Only = | Cp /Cv = | ||||
| 16) Flow Rates = | Max = | Normal = |
Flow Units = |
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| 17) Bore if calculating for Differential or Max Flow: |
Bore = | Maximum Differential Units = | |||
| 18) Vent or Drain = | |||||
| Notes:
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