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CUSTOM MANIFOLD ORDER FORM


                YES WE MAKE SPECIALS!


                      MANIFOLD STYLES




                                                                     QUANTITY:_____________________________
                                                                     MATERIAL:            STYLE:
                   SINGLE
                                   CENTER BULKHEAD
                                                                       Painted Steel         Single
                                                                       Stainless Steel       Center Bulkhead
                                                                                             Dual Outlet *see "D"
                                                                                             Stacked
              DUAL OUTLETS
                                                                     A) Quantity of Inlets per Tube ______________
                                         STACKED
                                                                      _____________________________________
                      B
                                        I                            B) Thread Size of Inlets (NPT)
                                                                         3/4", 1", 1-1/4", 1-1/2", 2" _______________
                                               INLET
                                                                      _____________________________________
                 G
                                                                     C) Quantity of Outlets per Tube ____________
                                                                      _____________________________________
                                                              J
                 F                                                 *  D) Outlet Location     T    R    B   L
                                                                                T                  T
                                                                           L        R      L                R
                                                                                B                  B

                    E                                                E) Thread Size of Outlets (NPT)
                                                                         1/4", 3/8", 1/2", 3/4", 1", 1-1/4", 1-1/2" _____
                                           OUT-
             H                              LET                       _____________________________________
                                                                     F) Outlet Spacing _______________________
                                                                     G) First Outlet Offset _____________________
                                                                     H) Tube Length _________________________
                                                                     I) Gap ________________________________
                                                                     J) First Strap, Location ___________________
                                                                     K) Second Strap, Location ________________
                                                                     L) Center Bulkhead     YES       NO

                                                                     Other: _________________________________
                                                             K
                                                                      ______________________________________
                                                                     M) 2-1/2" x 2-1/2" Std. Tube     YES       NO
                                                           M
                        M
                                                                         For other size specify __________________
                 Date:                          Purchase Order Number:
         Company:                                                 Name:
        Telephone:                                                   FAX:

                  PLASTIC PROCESS EQUIPMENT, INC.                                            www.ppe.com
                                                                                            e-mail: sales@ppe.com
                   E 8303 CORPORATE PARK DRIVE         W  6385 MONTESSOURI STREET
                  A MACEDONIA, OHIO 44056-2300         E  LAS VEGAS, NEVADA 89113-1186  Toll Free: USA, Canada & Mexico
                   S 216-367-7000 • FAX: 216-367-7022  S  702-433-6385 • FAX: 702-433-6388  800-362-0706
                   T TOLL FREE: 800-321-0562            T  TOLL FREE: 800-258-8877         Order Fax: 800-223-8305
        © Plastic Process Equipment, Inc. 2023  PPE Customers may copy this form as they need.                   605
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