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152 EM1-500 CUSTOMER INFORMATION
ERGONOMIC SOLUTIONS EFFICIENCY MASTER CONTAINER TYPE & SIZE
CONTACT:
COMPANY:
SURVEY SHEET
PHONE:
EMAIL:
LIP/DECK
WIDTH
CIRCLE ONE OR MORE:
PALLET
BASKET
LIP LENGTH
DECK IF OTHER, PLEASE DESCRIBE: GAYLORD OTHER
LENGTH
LENGTH: WIDTH:
HEIGHT: DIAMETER:
DECK LEVEL
HEIGHT STANDARD FEATURES
GUSSET DECK SIZE (CIRCLE ONE): 42” W x 50” L 48” W x 48” L 60” W x 50” L
CAPACITY (CIRCLE ONE): 2,000 LB. 4,000 LB. 6,000 LB.
OPTIONS (LIST ALL THAT APPLY)
”W ”L
SPECIAL DECK SIZE:
SPECIAL LIP SIZE (STANDARD IS 24” LONG.): ”W ”L
SPECIAL DECK LEVEL HEIGHT (STANDARD IS 24”):
LIP LOWERED HEIGHT (CIRCLE ONE):
SPECIAL ROTATION (90° STANDARD):
SPECIAL CAPACITY:
SPECIAL COLOR (STANDARD BLUE):
V-GROOVE ON DECK - LIST ROLL DIAMETER(S):
V-GROOVE ON LIP - LIST ROLL DIAMETER(S):
OPENING FOR PALLET - LIST PALLET HEIGHT(S):
POWER (460V, 3 PHASE STANDARD) IF CUSTOM, INDICATE BELOW
_____ A/C (110V _____ 220V _____ 460V _____ OTHER _____)
_____ SINGLE PHASE _____ THREE PHASE
_____ ROTARY AIR / HYDRAULIC (80 CFM @ 80 PSI, 1/2 GPM)
CONTROLS: _____ HAND _____ FOOT _____ AUTOMATED
POWER UNIT: _____ EXTERNAL _____ INTERNAL (STANDARD)
IF EXTERNAL, LENGTH OF CORDS (8’ STD):
IF ANY OTHER SPECIAL POWER OR
CONTROLS ARE REQUIRED, PLEASE INDICATE:
APPLICATION INFORMATION
DUTY CYCLE: STARTS PER HOUR: HOURS PER SHIFT:
SHIFTS PER DAY: DAYS PER WEEK:
ANTICIPATED CYCLE TIME:
SPECIAL TEMPERATURE REQUIREMENTS:
IS THIS A HAZARDOUS LOCATION? IF YES: CLASS: _______ DIV: _______ GROUP: ________
OTHER SPECIAL REQUESTS OR APPLICATION INFORMATION:
