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COMPONENT		1	2	3	MIXTURE

Fluid Name

Gas / Liquid

Flow Rate:	Max.
	Min.
	Norm.

Viscosity (cp.)

Density Kg/m3

Suspended solids present?

Particle Size
Are the components Soluble / Insoluble in each other

Surface tension dynes/cm)	:

Desired droplet or bubble size	:

Operating conditions	:	Pressure		Temperature

Flow Pattern	:	*Uniform

Plusating	:	Frequency (Cycles/Sec.)	Stroke Vol

Allowable Pressure Drop	:

Line

:

Size

OD

:

ID

:

NB

:

SCH

:

Material	:		Other (Please specify)	:

End Flanges	:		Other (Please specify)	:

Company Name*	:		Contact Person*	:

E-Mail*	:		Address*	:

Telephone	:		Telex	:

Fax	:		Date	:

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