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Accumulating Conveyor Application Form

Contact Information

* Contact Name:
* Company:
Address 1:
Address 2:
City:
State:		Zip/Postal Code:
* Phone:
Fax:
* Email:
* Required Fields

Please provide as much information as possible. We will be happy to assist you with questions: 859-291-0849

Specifications

1. Clutch is needed for:

New Machinery
Retrofit - to replace (Mfg., Model, Etc):

* 2. Clutch Mounting:

End of Shaft
Shaft Size (specify inches / mm):
Keyway (specify inches / mm):
Thru-Shaft (with reaction/torque arm)
Shaft Size (specify inches / mm):
Keyway (specify inches / mm):
Nema Frame (C-Face)
Frame Size:

* 3. Which will clutch drive when engaged (output)?

Sprocket(s)
Shaft

4. Sprocket Requirements:

Single
Double

Chain Size: # of Teeth:

5. Motor Specs:

HP:
RPM:
If not electric, please specify type here:

* 6. RPM at Clutch:

* 7. Cycle Rate (X per Minute):

* 8. Weight Per Zone (specify lbs / kg):

* 9. Line Speed (Velocity) (feet per minute / meters per second):

* 10. Roller Diameter (Specify inches / mm):

* 11. Ratio Between Roller and Clutch (If applicable):

12. Acceleration Time (seconds):

13. Deceleration Time (seconds):

14. Conveyor Coefficient Of Friction (If unknown we will assume 10%):

15. Operating Air Pressure Restrictions (if any):
Minimum (PSI): Maximum (PSI):

16. Envelope Restrictions (if any):
Maximum Length (specify inches / mm):
Maximum OD (specify inches / mm):

Additional Information
Please include any special requirements, environmental conditions, etc.