FlowX3 Assistance Application Form

Please provide as more details as possible for a prompt assistance.

Customer Information
First Name *
Last Name *
Company Name *
Address *
City *
Country *
Zip Code *
Telephone *
Fax *
E-mail *
Distributor
Customer Name
Customer Address
End User
Activity Field
Other Activity Field
Application details
Pipe Material
Pipe Size
Pipe Schedule
Working Pressure	MIN: MAX: TYP:
Working Temperature	MIN: MAX: TYP:

Fluid:
	Clean Dirty with solid
	% Concentration
	Dirty with Chemicals
	% Concentration Chemical
Fluid viscosity	(centipoises)
Fluid specific gravity	(Kg/m3)
Fluid conductivity	(µS)
Flow Rate	MIN: MAX: TYP:
Instrumentation description
Sensor
Other
Body material
O-ring material
Sensor location
Distance upstream of
Distance downstream of
Installation Fitting
Monitor
Other
Monitor Location	Local Remote
Distance from sensor
Power Supply
Message/Request

Please, enter the code you see above:

Send the forms on-line or by fax to FLS Technical Support at +39 010 96216214