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| * - Indicates Required Field | ||||
| Contact Name: * E-mail: * | ||||
| Company Name: Phone: * | ||||
| Street: Fax: | ||||
| City: State: Zip: | ||||
| Tank Style(s): Vertical __SAFE-TANK System ___Horizontal ___IBC | ||||
| Tank Size(s) (gallons): | ||||
| Tank Diameter(s): (if critical): | ||||
| Tank Height(s) (if critical): | ||||
| Tank Construction: If Other: | ||||
| Tank Color: If Other: | ||||
| Indoor Use __Outdoor Use | ||||
| Chemical / Concentration / Specific Gravity: | ||||
| Pressure: Atmospheric Only __ Other: | ||||
| Temperature: Ambient Only ___Other: | ||||
| Nozzles (Flanged): | ||||
| IMFO Nozzle: Yes ___No ___ If Yes, IMFO Tank Pad: Yes ___ No | ||||
| Nozzles (Threaded): | ||||
| Vent Style and Size: With Screen: Yes ___No | ||||
| Note: Unrestricted vent size must exceed size of tank's largest fitting by one inch; weighted hinged manway lid required if tank is filled pneumatically | ||||
| Weighted Hinged Manway Lid: Yes ___No | ||||
| Flexible Connections: Yes ___No | ||||
| Note: Flexible hose-type connections required to preserve warranty; allows for tank expansion / contraction and to reduce pump / piping vibration stress on the tank | ||||
| Wind Restraint System: No ___ Yes - Zone: MPH: | ||||
| Delivery Zip Code: Requested Ship Date: | ||||
| How did you find our web site? *
If referred, by whom? |
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| Notes / Comments: | ||||
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