System Application Form

Contact Info

High Purity Northwest, Inc.

8602 Maltby Rd.

Woodinville, WA 98072

Toll Free: 866-220-5118
West Coast: 206-782-2388

System Application Form

Tell us a little about what you’re looking for, and one of our experts will contact you to provide a customized recommendation for your particular filtration needs.

To narrow your scope of what you’re looking for, please fill out this form. Not all fields are necessary.

Company Name*
Contact Name*
Phone
Email*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Fluid Type
Fluid Mfg.
Fluid Viscosity Grade
Fluid Viscosity
Current Fluid Operating Temp.
Market & Application
Distance From Oil/Fluid Reservoir
Elevation Above or Below
Maximum Suction & Discharge Head/Elevation Distance from the Oil Reservoir
Critical Oil Serviced Component Types (check all that apply)
- Servo Valves
- Proportional Valves
- Flow Control Valves
- Pressure Control Valves
- Gear Pumps/Motors
- Vane & PistonPumps/Motors
- Bearings - What Type?
Is there a cooler as part of the oil system, (source), to maintain a constant fluid temperature?
- Yes
- No
What is the volume/size of the oil or hydraulic reservoir?
What is the operation environment temperature, (location unit will be used in)?
What is the operating oil temperature?
Oil/Fluid Source Total Volume (gallons)
How many access ports are on the oil reservoir?
Desired material of unit, (Carbon or Stainless Steel)
Will the unit be unsed in a hazardous environment? If yes, please specify:(area classification, example, class 1 div 1, class 2 div 2)
What is the contaminated oil stored in? (reservoir, drums, totes, etc.)
What fittings are available as part of the oil reservoir? (Type and size)?
Should any new system include a laser particle counter and/or moisture in oil content display?
Available power supply, (phase, voltage, amperage)
Additional Information Not Specified Above

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System Application Form

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