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Fluid Layout Ambient

Name

First

Last

Email

Phone Number

Subject

Comments/Additional Information

Chiller Information:

Condensing Method

Ambient Air Temperature F

Entering Fluid Temperature F

Fluid Flow Rate (G/PM)

Required Capacity (BTUH)

Water %

Fluid to be Cooled:

Ethylene Glycol %

Propylene Glycol %

Other % (Please Specify)

Power Requirements:

Voltage

Phase

Cycle

Options:

Others (Please specify):