Engineered Gasketing Products

Gasket Application Data FormDate ____________________________________ From ___________________________________For: Garlock Gasketing EngineeringTitle ____________________________________Fax 315-597-3290Company ________________________________Page: 1 of _______________________________ Address _________________________________Drawing attached ❑ Yes ❑ No City / State / Zip ___________________________Phone __________________________________Fax ____________________________________E-mail __________________________________❑ Pipe Flange❑ Heat Exchanger❑ Manway❑ CompressorApplication❑ Pumps – centrifugal / horizontal split case❑ Flue Duct❑ Valve Bonnet❑ Other ________________________________Service ConditionsMaximum Temperature ________________ °F / °C Continuous Operating Temperature ______ °F / °CInternal Pressure ___________________psig / bar PSIG / bar ❑ Continuous ❑ IntermittentThermal Cycling ___________________/ 24 hours Vibration ❑ Yes ❑ NoOther (specify)_______________________________________________________________________BoltsGrade ___________________________________ Diameter ________________________________Length __________________________________ Number _________________________________Chemical CompatibilityMedia ___________________________________ pH _____________________________________Concentration ____________________________ Liquid or Gas _____________________________FlangeStandardNon-StandardMaterial _________________________________ Material _________________________________Size ______________ Rating _____________ I.D. / O.D. ________________________________Surface Finish ________________________RMS Flange Thickness _________________________❑ Phonographic ❑ Concentric Bolt Circle Diameter _______________________Face (raised, flat, tongue & groove, etc.) _______ Surface Finish ________________________ RMS________________________________________ ❑ Phonographic ❑ ConcentricFace (raised, flat, tongue & groove, etc.) ______________________________________________Comments: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Questions? Call Gasket Applications Engineering at 1-800-448-6688C-58