Southestern Hose, Inc. | Expansion Joint Quote Request

Expansion Joint Application Specification Form
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To fax this form:
Please print, complete, and fax to 770-537-5573.

To help us better assist you and to ensure a timely response, please supply us with the most complete and accurate information. Please see "special requirements and additional information" to list any items not shown on this form.

*Company
*Contact
*E-mail
Phone
Fax
Project
Inquiry/Job No.
Quantity
Date Required
Item/Style
Nominal Size
I.D.	(in.)
O.D.	(in.)
Overall Length (OAL)	(in.)
Pressure
Working	(psi)
Test	(psi)
Design	(psi)
Temperature
Design	(�F.)
Max./Min.	(�F.)
Installation	(�F.)
Expansion Joint Type

Fluid Information
Flowing Medium
Flow Velocity	ft./sec.
Flow Direction
Maximum Installation Movement
Axial Compression	(in.)
Axial Extension	(in.)
Lateral Deflection	(in.)
Angular Rotation	�
Maximum Design Movement
Axial Compression	(in.)
Axial Extension	(in.)
Lateral Deflection	(in.)
Angular Rotation	�
No. of Cycles
Operating Fluctuations
Axial Compression	(in.)
Axial Extension	(in.)
Lateral Deflection	(in.)
Angular Rotation	�
No. of Cycles
Materials of Construction
Bellows
Pipe (if required)
Liner (if required)
Cover (if required)
End Fittings
Fitting #1
Size
Type
Material
Fitting #2
Size
Type
Material
Other Material Specifications
Rods (Tie/Limit/Control)
Anchor Base (Main/Intermediate)
Dimensional Limitations
Min. I.D.	(in.)
Max. O.D.	(in.)
Spring Force
Axial	(lbs./in.)
Lateral	(lbs./in.)
Angular	(lbs./in.)
End Movement	(lbs./in.)
Installation Position

Vibration Amplitude/Frequency

Cyclic Design Life

Purge Instrumentation Connection

Quality Assurance Requirements
ASME Code Partial Data Forms Required
Applicable Codes and Specifications
Special Flange Design
Facing
I.D.
O.D.
Thickness
B.C. Diameter
No. Holes
Size Holes
Hole Orientation
Special Requirements or Additional Information