User Application Data Form

bg_gold_gradient40 (1K)

For more information regarding A.T.Monitors' full product line, you can view or download our product datasheets on the Monitors and Sensors pages.  For information concerning a specific liquid monitoring application, please fill out and submit the following form.

NOTE: Marked fields (») must be filled in before submitting this form.
 

Company Information

»COMPANY:
CONTACT NAME:
»ADDRESS:
»CITY:
»PROV./ STATE:
POSTAL / ZIP CODE:
COUNTRY:
 
PHONE NUMBER:
FAX NUMBER:
»E-MAIL ADDRESS:
 

Application Specifics

Type of Application:
If other, please specify:
Area Classification/Conditions:
Primary Type of Containment: Double-wall tank
Single-wall tank
Concrete tank
Pipeline
Location of containment: Underground
Above-ground
Indoors
Rooftop
Additional site details:
Are there monitoring wells?: Yes,  How many?
Are there project specifications?: Yes
Product to be Detected/Measured:
Number of Detection Points:
Multiple liquid levels at some points?: Yes,  How many levels?
Petroleum vapours at some locations?: Yes
Other Product(s) Present:
Maximum Sensor to Monitor Distance: feet, meters
Temperature in Monitoring Area: min. max. °C, °F
Relative Humidity in Area: %
Any condensation present?: Yes
 

Monitor

VOLTAGES (DC, AC/Hz) available on site:  

SPECIFIC OUTPUTS (please check)

INDICATORS: Status LEDs
Audible Alarm(s)
Battery-low Indicator
DISPLAY(S): Not required
Bargraph
Numeric
OUTPUT RELAYS: Each channel
Single Common Relay
RELAY RATINGS (specify):   Contacts (ie: SPDT)
  Current (Amps)
  Voltage VAC, VDC
  Horsepower

OPTIONAL ITEMS (please check)

BATTERY BACKUP: Not required
Internal
External
ENCLOSURE TYPE: NEMA-4X
Explosion Proof
Other (specify):
PROJECT STAGE: Design
Tender/Bid
Purchasing
 
ADDITIONAL COMMENTS:  

 

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