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PARJET CO., LTD.
ENGINEERING DESIGN REQUEST FORM
*
Company:
Division:
Address:
Zip Code:
*
Contact Person:
*
Contact Number:
*
E-mail:
Fax:
Application:
Current Seal:
P/N:
Newly-designed Seal:
Annual Usage:
Quote Quantity:
Problem(s) with Current Seal:
Silicon Filled (FDA available):
Yes
No
Seal Motion:
Static
Rotary
Reciprocating
Seal Type:
Rod
Piston
Face Seal
System Pressure:
Internal
External
RPM:
Rotation:
Stroke Length:
Velocity:
System Pressure:
Pressure Direction:
Unidirectional
Bidirectional
Temperature:
Media:
A
B
C
D
A
B
C
D
E
A
B
C
A
B
C
*
Verification:
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