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Applications Request
Note:
Input denoted by
*
are required.
General Information
Company name
*
:
Contact name
*
:
Street address
*
:
Phone number:
(
)
-
FAX number:
(
)
-
City, State, Zip
*
:
,
,
Email:
*
Application Information
Proposal Requested:
Select One
Budgetary
Firm
Date Proposal Needed:
Air pressure at install area:
Size of line at install area:
Maximum cycles per hour:
Shifts per day:
Electrical:
110
230, 3 phase
460, 3 phase
Product(s) to be handled:
Current handling method:
Weight (lbs)
Height
Width
Length
ID
OD
Maximum
Minimum
Maximum/minimum reach needed:
/
Inches from centerline of manipulator:
Distance to bottom of product at lowest position:
Distance to bottom of product at highest position:
Please indicate where measurement was taken from (floor, platform, etc.):
Clearance Factors
Distance to lowest fixed overhead obstruction that cannot or would not be moved:
inches from floor.
Obstruction:
Mounting Preference
Select one:
Floor Mounted Jib Crane
Overhead Mounted Bridge Crane
Floor Mounted Bridge Crane
Pallet Inverter
Articulating Boom Jib Crane
Tool Balancers
Air Balancers
Vacuum Lifters
Industrial Manipulators
End Tooling Preference
Select one:
Hook
Manipulator
Gripper
90° Tilt
Vacuum
180° Tilt
Magnetic
Other
Special Handling Considerations
Grip area, pressure, temperature, other, describe:
Comments and Sequence of Operation
Contact us @ 800.223.6430
or
email us @
info@ergonomichandling.com
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