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CHECK LIST FOR APPLICATION DATA

A. General This form is filled by:(*)
Company:(*)
E-mail:(*)
Phone:(*)
Date:(*) (dd/mm/yyyy)
B. Customer Contact person:
Problem description:
Potential pieces /year:(*)
Misc
C. Application    
  Drawing enclosed: (max. 1Mb)
  Modification possible:


D. Enviroment
  Media temp (°C):(*) max norm min
  Pressure (bar):(*) max norm min
  Media: dry
  grease type:
  oil type:
  water
  dust
  misc.
  Level of media :
  below seal
  mid of shaft
  over seal
  Misc.:
E. Shaft
  Diameter (mm):(*) Tolerance:
  Drawing enclosed: (max. 1Mb)
  Rotating shaft Speed (m/s) :(*)
  Direction of rotation:
  (seen from air side)
  Material: Finish:
  Hardness: Treatment:
  Axial movement: run-out:
  Misc.:
F. Housing
  Diameter (mm):(*) Tolerance:
  Height (mm):
  Drawing enclosed: (max. 1Mb)
  Rotating shaft Speed:
  Direction of rotation:
  (seen from air side)
  Material: Finish:
  Hardness: Treatment:
  Axial movement: Bore to shaft
misalig. :
  Misc.:
G. Seal
  Drawing enclosed: (max. 1Mb)
  Type-dimensions:
  Material:
  Misc.:
* required field