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General Information

Who Are You?

End User
Distributor
System Integrator
Original Equipment Manufacturer

End User: A company that uses material handling equipment to aid in the manufacture of their product line.

Distributor: A company that typically sells allied material handling products including rack, mezzanies, cranes, hoists, scissor lifts, manipulators, etc.

System Integrator: A company that identifies purchases and manages the integration of various component parts and services to provide an automated solution to end user customers.

Original Equipment Manufacturer (OEM): Companies that manufacture equipment as the primary business focus and incorporates material handling component parts in the design of their product.

Name*

First Last

Company*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email*

Project Reference

Timeframe for Project Order

Timeframe for Quote/Proposal

Pricing Requirement:

Budget
Firm

Select Product Type*

Conveyor Application Form

Detailed sequence of operation:

Product being conveyed?

Product temperature range?

Low High

°F
°C

Ambient

Ambient

Condition of the containers and bottom surface?

Container material contacting the conveyor surface?

Bottom configuration of the container contacting the conveyor surface?

Maximum length of the product (in direction of travel)?

Maximum width of the product?

Maximum weight of the product being conveyed?

Maximum total live load (moving weight) on the conveyor?

Configuration and orientation to the direction of travel?

Environment temperature range?

Low High

°F
°C

Ambient

Ambient

Other environmental factors?

Oil
Moisture/Humidity
Dust
Abrasive Material
Other

Please specify:

Will accumulation (aggregation of containers) occur on the conveyor?

Yes
No

Zero pressure accumulation (containers don't touch each other) required?

Yes
No

Is minimum pressure accumulation (containers touch each other, but the driving force is minimal) required?

Yes
No

Are we to determine the decline angle for the product to flow?

Yes
No

Elevation

Beginning End

How will the conveyor be loaded?

Shock to the system during loading?

Yes
No

How will the conveyor be unloaded?

Will the conveyor start/stop under full load?

Yes
No

Does the conveyor need to reverse?

Yes
No

How many hours per day will the conveyor run?

What is the rate of product per hour?

Belt speed - fpm (feet per minute):

Roller Bearings:

non-precision
semi-precision
precision

Special motor needs:

Brand

Voltage

Phase

Cycles

Special reducer brand?

Belt or chain recommendation or preference?

Special paint:

Yes
No

RAL number

Sample to be provided

Yes
No

Will sketches be provided?

Yes
No

Will layout drawings be provided?

Yes
No

Corporate specifications:

Other special requirements:

Available power supply:

480/3/60
240/1/60
110/1/60
Other

Other power supply:

Type of controls required:

At-motor disconnect switch
Proximity switch
Limit switch
Photo eye
Pneumatic control valves

Motor starter:

Across the line (fixed speed)
Variable frequency drive (variable speed)
Manual (basic switch operation)

E-Stop:

Remote pushbutton station (mushroom)
Pull-cable type

Other special devices:

Other special requirements:

Phone

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LEWCO Product Configurator

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