Job Information Sheet Need to download and fax this sheet instead? Click here to download the PDF. Please give us your information so we can quickly address your needs. Full Name*(Required) Full Name* Phone(Required)Estimated date MM slash DD slash YYYY Day Shift, Night Shift or Around the Clock? Customer Location Unit/Equipment No. Customer's Concern (select all that apply):Customer's Concern (select all that apply): Speed Thoroughness Other If Other, please specify your concern:Description of JobJob Type (select all that apply):Job Type (select all that apply): Heat Exchanger Ground Level Vertical Pipe Elevated Horizontal Other If Other, please specify your concern:CommentsComplete the Appropriate SectionComplete the Appropriate Section Exchanger Pipes Select all that apply:Select all that apply: Straight Looped U-shaped Age/Condition# of Tubes to Clear Tube OD Wall ID Tube Material Schedule Gauge Channel Head? (check if yes) Channel Head? (check if yes) If there is a Channel Head, specify depth: Has Baffles? (check if yes) Has Baffles? (check if yes) If there are Baffles, please describe: Tube Ends Tube Sheet Diameter Length Drawings Available?(check if yes) Drawings Available? (check if yes) Select all that apply:Select all that apply: Straight Looped U-shaped 90° Turns? (check if yes) 90° Turns? (check if yes) Age/Condition # of Pipes to Clear Pipe OD Wall ID Length Pipe Material Schedule Gauge Has In-Line Flanges? (check if yes) Has In-Line Flanges? (check if yes) Number of Flanges Gasket Type Has In-Line Welds? (check if yes) Has In-Line Welds? (check if yes) Entry Into Pipe (select all that apply):Entry Into Pipe (select all that apply): Flange Thread Other Line is Jacketed? (check if yes) Line is Jacketed? (check if yes) Drawings Available? (check if yes) Drawings Available? (check if yes) CommentsCAPTCHA
