Custom Lance Intake Sheet Please fill out the following form as completely as possible to assist in the lance design process. Contact Information: Date: Process Lance is Used in: Codes: Design Code/Registration: Design Vessel Pressure: Design Vessel Temperature: Design Liquid Pressure: Design Liquid Temperature: Corrosion Allowance: Additional Testing/QC Requirements: NDE Type Extent of NDE and on what components Radiographic Test Ultrasonic Test Other (specify) Material Test Reports Weld Procedure Approval Spray Nozzle Selection: What Liquid is being Sprayed: Liquid Flow Rate: Air/ Steam Flow Rate: Spray Pattern: Full Cone Specific Gravity: Liquid Pressure Drop: Air/Steam Pressure Drop: Hollow Cone Nozzle Spray Angle: Nozzle Material: Specify any erosive or corrosive conditions present: Nozzle Connection Size: Nozzle Connection Style: Nozzle Model (if known): Is a tack weld required for threaded nozzles? Pick One See next page for lance layout design 50 Greenfield St., Greenfield, MA 01301 USA TEL: 413-772-0846, TOLL FREE: 800-235-0049, FAX: 413-772-6729, EMAIL: [email protected]

CUSTOMER SPECIFIED CUSTOMER SPECIFIED LIQUID INLET CONN TO BE DETERMINED BY CUSTOMER Conn Size:_____________ NOZZLE SERIES TO BE DETERMINED BY CUSTOMER Nozzle Series:____________ Conn Type:_________________ Conn Rating:_______________ Conn Material:_____________ MOUNTING FLANGE TO BE DETERMINED BY CUSTOMER Flange Size:_____________ Flange Type:_________________ Flange Rating:_______________ Flange Material:_____________ BETE FOG NOZZLE, INC. 50 GREENFIELD STREET GREENFIELD, MASSACHUSETTS 01301 UNLESS OTHERWISE NOTED, REMOVE ALL BURRS AND SHARP EDGES THIS PRINT CONTAINS PROPRIETARY INFORMATION...