Application Data Sheet

Company Name:
Street Address:
City, State, Zip:
Contact Person:
Email:
Phone:
Fax:
Proposal Requested: Budgetry
  Firm
Need Proposal Date: mm dd yyyy
Products to be Handled:
Number of Products:
Name & Part Numbers:
Weight(lbs)
Height Width Length I.D. O.D.
Max.
Min.
   
Environmental Data:
  Corrosive
  Dusty
  Abrasive
  Explosive
  Clean
Temperature Normal 65 - 85F
  Hot F
  Cold F
   
Utilities Available:
  Electrical:
  110V 1PH
  230V 3PH
  460V 3PH
  Other V PH
   
  Air Pressure @ Install Location:
  80-90 PSI
  90-100
  100+
  Other
   
Current Handling:
Methods:  
  Manual
  Forklift
  Crane
  Robot
  New
   
Operation Data:  
  Max. Number of Cycles/HRS
 
   
  Number of Shifts/Days
 
   
Sequence of Operation:
  Max. Reach Needed:
  Inches From Center Line of Manipulator
   
  Min. Reach Needed:
  Inches From Center Line of Manipulator
   
  Distance to Bottom of Product at Lowest Position:
  Inches
   
  Distance to Bottom of Product at Highest Position:
  Inches
   
  Please Indicate Where Measurement was Taken From:
 
(Floor, Platform, Etc.)
   
 

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Advanced Manipulator Specialists, Inc. | Phone: (320) 986-2194 | Fax: 320-986-2193
123 Memorial Drive NW, PO Box 65, Hoffman, MN 56339

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