Light
Duty Thermostat
Questionnaire
Caltherm
Corporation
Company
Name: _______________________________________________
Address:______________________________________________________
Telephone/Fax:_________________________________________________
Company
Contact:______________________________________________
_____________________________________________________________
Application
Description:
_____________________________________________________________
_____________________________________________________________
Anticipated annual usage: ____________
Calibration:
Start to Open Temperature:
_______ @ RPM
Full Open Temperature: _______ @RPM
Minimum
Flow and Maximum Pressure requirements
Minimum full-open time response requirement:
Maximum full-open pressure drop allowed:
Time
response
Start-to-open to full-open time response:
Full-open to start-to-open time response:
Maximum
Operating Temperature:
Max
Over-temperature:
Thermostat
Orientation (Horizontal, Vertical, Other):
Venting
Devices
Jiggle Pin:
Ball Valve:
Hole:
Notch in Seat or Valve:
Vent on Outlet Connector:
Independent Vent:
Leakage
requirements:
Flange Seal:
Rubber Valves:
Locktite:
Gasket
Style
Flat Gasket:
O-ring:
U-Seal:
Main
Valve Style:
Sleeve:
Reverse
Poppet:
Metal: _____
Soft:
_____
Pilot:
_____
Bypass
Poppet Required:
Bypass
Poppet Valve Style:
Rubber Coated:
Spring Loaded vs. Stationary:
Weld vs. Press Fit:
Bridge
Type:
Std:
Button:
Crimped Piston:
Thermostat
Normally Open or Normally Closed:
_____
Dimensional
Limitations: _____
Qualification
Requirements: _____
Duty
Cycle:
Life
Requirements/Service Interval:
Element
Type:
Flat Diaphragm:
Squeeze-Push:
Please copy and mail or fax completed questionnaire to Caltherm address below.
Caltherm Corporation
910 S Gladstone Ave
Columbus, IN 47201
(812) 372-0281 * FAX (812) 376-8305