14th-Edition-BriskHeat-Product-Catalog A | Page 140

APPLICATION QUESTIONNAIRE

Your Heating Specialist since 1949

General Heating Application Questionnaire: Part I
Company:

Phone Number:

Contact Name:

Email or Fax:

Address:
Application:
Type of Industry:

PART A: OBJECT TO BE HEATED
Object that needs heat:
Unit of measurement?

Dimensions of object: (Please include a drawing or sketch)
Cylinder:

Rectangle/Cube:

Diameter:

X Length:

Length:

X Width

X Height

Multiple objects with varying dimensions
Object wall thickness:
Are there any obstructions or clearance issues that may restrict heater placement?:
If yes, please provide documentation.
Material of Object(s):

Steel

Stainless Steel

Non-Metal

Yes

No

Other

Content: Name:
Flow rate:
Beginning state:

Gas

Liquid

Desired ending state:

Solid

Gas

Liquid

Solid

PART B: ENVIRONMENT
Unit of measurement?

ºC

ºF
º

Ambient Temperature: Maximum
Environment: (check all that apply)

º

Minimum

Indoor

Moisture

Outdoor, Wind Speed:
Division

Hazardous-Area, Class
Cleanroom, Class

Chemical

Group

Other

PART C: HEAT REQUIREMENTS
APPENDIX

Unit of measurement?

ºC

ºF
º

Starting content / object temperature:
Heat up to:

º, within

Maintain at:

º

Hours

but never below:

Will you provide insulation?:

No

º

and never above:
Thickness:

Yes, Type:
Will it cover all surfaces?:

A-2

Toll Free: 800-848-7673

Phone: [phone]

w w w .BriskHeat. c o m

º

Yes

No, please explain:

Email: [e-mail] Fax: [phone]

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