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Name:*

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Phone

Medium

Potable Industrial Cooling Tower Grey Other (Specify Below)

Pipe Size

Max Flow Rate

GPM CFH Other (Specify Below)

Maximum Pressure

PSI " WC Other (Specify Below)

Location

Indoor Outdoor Unknown

Cold or Hot Water Meter

Cold Hot

Max Temperature (Hot Water Only)

°F °C

Orientation

Horizontal Verticle Up Verticle Down Unknown

Meter Output

None Pulser Encoder Wireless

Register Units

Gallons Cubic Feet Other (Specify Below)

Required quantity of meters described on this form

Additional Information

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