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Product Application Worksheet
First Name*
Job Title
Last Name*
Phone
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Company
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System Requirements
Please briefly describe the intended use of your gauge*
Mechanical Requirements
Range*
Choose an option
30 inHg to 0 psi
30 inHg to 15 psi
30 inHg to 30 psi
30 inHg to 60 psi
30 inHg to 100 psi
30 inHg to 160 psi
30 inHg to 200 psi
30 inHg to 300 psi
0 to 15 psi
0 to 30 psi
0 to 60 psi
0 to 100 psi
0 to 150 psi
0 to 160 psi
0 to 200 psi
0 to 250 psi
0 to 300 psi
0 to 400 psi
0 to 500 psi
0 to 600 psi
0 to 800 psi
0 to 1000 psi
0 to 1500 psi
0 to 2000 psi
0 to 3000 psi
Custom Ranges
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Pressure Fitting*
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1/4" Male Face Seal Fixed
1/4" Female Face Seal Fixed
1/4" Male Face Seal Swivel
1/4" Female Face Seal Swivel
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Mount Location
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Center
Lower Back
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Additional Requirements
Initial Quantity Needed
Estimated Annual Quantity Needed
First Delivery Date
Please list any special requirements or value added services Wasco could perform (Example: Cable Harnessing or Helium Leak Testing)
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