REQUEST FOR QUOTE HEAT TRACE

Project Name:

Project Location:

Project Phase:

Quote Due Date:

1. What voltages are available?

ctrl + click to select multiple items

2. What type of location are the pipes located in?
Please check all that apply.

indoor
outdoor
non-hazardous
hazardous
other, please specify:

3. What type of fluid is flowing through the pipe?

please specify:

4. How many pipe lines are you tracing?

please submit multiple requests if necessary.

5. Please provide the following information for each pipe line:

a. Pipe #
b. Pipe Length
c. Pipe diameter
d. Type of insulation
e. Thickness of insulation
f. Maintain temperature
g. Lowest expected ambient temp.
h. Wind speed (if applicable)
i. Pipe material		please specify

6. Please list quantity and size of the following on the pipeline:

	Quantity	Size
screw valve
flange valve
butterfly valve
pipe supports
pipe elbows
pipe flanges

7. What is the distance to the nearest junction box or control?

8. What type of cable would you like us to quote?
please check all that apply

MI single conductor snow melting cable assembly
MI dual conductor snow melting cable assembly
SR cable
CW cable
please recommend

9. What type of control and/or panel do you need?
please check all that apply

Thermostat
Thermostat with monitor light
TraceMate
GFPE Power Relay Panel
Enclosed Control/Monitor Panel
Custom Control/Monitor Panel
please recommend

*Name:	* required
Company:
*Phone:
Fax:
*E-Mail:
Address 1:
Address 2:
*City:
*State/Zip:
Role:	*Other
Where did you learn of Delta-Therm?
Please include the name of the publication, show, search engine, person, etc.
Comments:

On the next page you can submit a plan or sketch.

Quote Forms:

Floor Warming System

Freeze Protection or Process Heating System

Roof Deicing System

Slab Snow Melting System

Stair Snow Melting System

Tank Tracing System

Custom Monitor and/or Alarm Panel