Conveyor Belts & Belting Corp | Specifications Form

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1-800-540-1846
CONVEYOR BELT
SPECIFICATION FORM

Please fill in the fields below, then click "Submit" to send your specs to us. Or, of you prefer, you may print out this completed form and either send it to us by fax (207-563-8457) or by regular postal mail (MIPR CORP, PO Box 381, Newcastle, ME 04553).

CONTACT PARTICULARS
Name
Company
Address
City
State
Zip
Country
Phone
Fax
Email

PRODUCT
Part No./Manufacturer
Material	(Meat, bones, cardboard, steel, etc.)
Weight	lbs. per foot
Dimensions
Shape
Temperature
Description	Dry Wet Sticky Threads Corrosive Fluffy Compact Abrasion: Chemicals: Oily: Other:
PROCESS
Description	Cutting Sorting Molding Heating Sealing Other:
Conveying Method
Movement/Speed	(Merging, accumulation, acceleration/deceleration, etc.)
LAYOUT
Type	Horizontal Incline Decline Degree of incline/decline:
Slider Bed	Metal Stainless Wood Plastic Dimpled Rollers/Idlers
If Rollers/Idlers	Distance between idlers: Dimension of rollers: Arc of contact of pulley: Distance between pulleys: Pulley size: Bare or lagged:
Drive Location	Head Pulley Tail Pulley
Scraper & Cleaning Blade	Type: Position:
Take-Up Type	Screw Gravity Other
Belt Specs	Width: Length: Top Cover Color: Overall Gauge: Number of plies: Tension (PIW): Coefficient of friction: Cover profile: Speed (ft/min or meter/min):
Fabrication	Stainless: Mild steel: Mechanical lacing (type/number): Plastic staple lace Spiral lace Standard Flap Recessed Hidden Other If Other:
Endless?	Yes No If "Yes," check one: Finger splice Step splice Skived/bevel splice Longitudinal splice Finger-step-finger splice Other:
Cleat?	Yes No If "Yes": Type: Height: Centers: Check if applicable: Indented Tapered
Sidewalls	Type: Height:
OPERATING ENVIRONMENT
Conditions	Indoors Outdoors Ambient Temperature:
Cleaning	Chemicals: Steam Other
Conductive	Static Non-static
Dust environment?	Yes No
Product accumulation on belt?	Yes No
Use	Continuous Intermittent hours/day
STANDARDS
Please check one	FDA USDA AAA NSA None Other If "Other":
NOTES/COMMENTS
Previous belt info:
Belt failure info:
Reason for replacement:
In service: years
Other notes:

Or just call in (sk for Henry or Whitney):
1-800-540-1846

© A division of MIPR CORP
21 Teague Street PO Box 381 Newcastle, ME 04553
Phone: (207) 563-5532 Email: HGL@TIDEWATER.NET Fax: (207) 563-8457

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