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When evaluating hose applications, we use the acronym "S.T.A.M.P.E.D." to be sure we ask all the right questions.
Please help us by completing the following regarding your specific hose requirements:                                                                                               

SIZE
Inside Hose Diameter:

Outside Hose Diameter (if known):
 
TEMPERATURE
Temperature of material going through the hose:

Temperature of environment outside the hose:
 
APPLICATION:
What is the hose being used for?
MEDIA
What is the product to be conveyed?
PRESSURE
At what pressure will the hose be operating? Does the pressure dramatically increase "spike"?
ENDS
What hose ends are needed? (i.e., male/female, pipe thread, jic, metric, etc.)
DELIVERY
When do you need the product delivered?
QUANTITY/ ADDITIONAL INFORMATION
Is there any other information we should know?
*Company
*Name:
*Address:
*City:
 		 *State/Prov:
 
Country:
 		 *Zip/Post. Code:
 
*Phone:
 
*E-mail:
 
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1061 W. Jackson Blvd. • Chicago, IL 60607 • Tel: 312.666.5030 •Toll: 866.666.5030 • Fax: 312-666-3717 • sales@alliancehose.com