Company Name, Address, Phone, Fax:
____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

E-mail address:________________________________

Measurement Preference:  Bushels____ Pounds____ Tons____

A: Bucket width (inches)_________________________

B: Bucket depth/projection (inches):_________________

C: Head pulley Diameter (inches):____________________

D: Head pulley width (inches):_______________________

E: Inside depth of trunk (inches):_____________________

F: Inside width of trunk (inches):_____________________

G: Clearance between trunks (inches):_________________

H: Centerline to Centerline distance
     of bearings (inches):____________________________

Head pulley shaft diameter (inches):___________________

Present head pulley speed (RPM)____________________

Boot pulley shaft diameter (inches):___________________

Overall height
(Bottom to head), (feet):___________________________

Distance between pulley centers (feet):________________

Belt width (inches):_______________________________

Products currently being conveyed___________________
_____________________________________________

Present capacity (lbs. per hour):_____________________

Products to be conveyed after conversion:______________
______________________________________________

Future capacity required (lbs. per hour):________________

Current horsepower:______________________________

Original elevator manufacturer:_______________________

Elevator is located?   Indoors____ Outdoors____ Both____

Other comments:__________________________________
_______________________________________________
_______________________________________________

Fax completed pages to:  (763) 428-4411