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Contact Person

Phone

Email Address

Jobsite Location

Design Pressure

Design Vacuum

Design Temp (deg F)

Buried or Above Ground Buried or Above GroundBuriedAbove Ground

Resin Type or Chemical Environment – Type & Concentration two separate

Corrosion Liner Thickness Corrosion Liner ThicknessNo Liner100 mils120 mils140 mils200 mils500 milsOther

Fire Retardant Fire RetardantYesNo

Joint Connections Joint ConnectionsButt/WrapThreadedBell Spigot

Filament Wound or Hand Lay Up Filament Wound or Hand Lay UpFilament WoundHand Lay Up

Date Quotation Is Required

Anticipated Project Need Date

Any special requirements (i.e.: pipe stress analysis, ISO drawings, pipe supports, field installation, bolting/gaskets, expansion joints)