Drivelines Northwest - Applications

Driveline Order Information

1) Please answer the following questions as accurately as possible. This information will help us ensure that the shaft will meet your needs, last for years, and above all, be safe during operation

2) Once we receive your initial requirements a technician will review them and then contact you to complete the order process.

3) At anytime, please feel free to contact us about your project by phone @ 800.552.7647.

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Customer Information

First Name:		Last Name:

e-mail:		Company:

Phone:		Fax:

Address:		State: ( or Providence)

City:		Country:

Postal Code:

Engine Information

1. Prime Mover:	Gas Diesel AC Electric DC Electric Other
	Gas Diesel AC Electric DC Electric Other
2. Type or Model:
3. No. of Cylinders:
4. Operating Time%:
5. Maximum Output (HP):		at speed RPM
6. Maximum Torque:		at speed RPM
7. Gear Ratio:
8. Clutch Type:		(if used)
9. Elastomeric Coupling:		Need Have N/A

Driven Equipment

Driven Equipment:
(f.i. Transmission, ventilation fan, pump)

Flange Information

Flange OD :	Drive End :	Driven End :
Bolt Circle diameter :	Drive End :	Driven End :
Pilot Diameter :	Drive End :	Driven End :
Number of bolt holes: Size of bolt holes:	Drive End :	Driven End :

Driveline Information

Desired life expectancy:	approx. Hrs.
Estimated requirement	approx. parts per
Max. distance between flanges: