Parker Titan Industrial Hose Division - Goodyear Rubber Products, Inc.
Parker Titan Industrial Hose Division - Goodyear Rubber Products, Inc.
Parker Titan Industrial Hose Division - Goodyear Rubber Products, Inc.
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Product Recommendation Form<br />
Customer Information: Date:<br />
Company: Contact:<br />
Address: Phone:<br />
Size<br />
Temperature<br />
Application<br />
Material<br />
Pressure<br />
Ends<br />
Delivery<br />
Special<br />
Requirements<br />
Other Information<br />
Fax:<br />
I.D. O.D. Overall Length Tolerance<br />
Material being Conveyed Outside Exposure<br />
Min. (˚F or ˚C) Max. (˚F or ˚C) Min. (˚F or ˚C) Max. (˚F or ˚C)<br />
Type of Service<br />
Indoor/Outdoor Flexibility Required External Conditions<br />
Intermittent/Continuous Use Electrical Static Conductive<br />
Type of Service<br />
Working Pressure W.P. <strong>Inc</strong>l. Surges Burst Pressure Vacuum Required<br />
End Style Attachment Method Material Threads/Bolt Hole<br />
#1<br />
#2<br />
Quantity Date Required Ship Via<br />
Required Testing Required Certification<br />
Color Private Branding Special Packaging<br />
Fax To: <strong>Titan</strong> Industries Customer Service Department 562.869.05.92<br />
Form is available for download at our website<br />
www.titanindustries.com<br />
800-242-HOSE (4673) • Fax 562.869.05.92<br />
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