BOILER FEED PUMP REQUEST FORM
FOR NEW INSTALLATION
Power Plus International
Ph: 1-800-780-3776
Fax: 770-957-9563
| GPM: | ____________ |
| Ft of Head: | ____________ |
| -or- | |
| PSI: | ____________ |
| Material of tank: | Cast Steel |
| Cast Iron | |
| Stainless Steel | |
| Boiler Information | |
| HP of Boiler: | ____________ |
| PSI of Boiler: | ____________ |
| Output PPH of Boiler | ____________ |
| Any options you may need: | |
| Name: | _____________________________________________ |
| Company: | _____________________________________________ |
| Phone: | _______________________________ |
| Fax: | _______________________________ |