Temperature Element Request Form

Name*

Address*

Title

Address

Company*

City*

Phone*

State*

Fax*

Zip*

E-mail*

Country*

Please fill in as many fields as possible - manufacturer standard options will apply unless directed otherwise. To submit the form for the quickest quotation the fields marked with ( * ) should be completed.  N/A, vendor select or unknown are acceptable inputs.  If you have any questions, please contact KECO at 732-901-5900 or keco@optonline.net.
Type of unit required
Manufacturer (list any preference)
Model number (if known)
Quantity *
Tag number - if required, list type and info
Fluid / Media *
Temperature range-value and units *
Type of element
Element construction
Sheath diameter
Sheath material
Length of element
Thermowell
Element connection style to thermowell or process

Process connection size

Cold end termination, electrical connection/wiring to system

Lead wire - insulation & type, list gauge if known

Lead wire protection - if applicable

Extension assemblies, choose style & material, list length if non-standard

Temperature transmitter - if needed, list output

Comments / Other available information / special requirements or considerations

Thank you for contacting Keco Engineered Controls
1200 River Avenue Bldg. 3A   Lakewood, NJ 08701-5657
Phone: 732 901-5900 Fax: 732 901-5904
E-mail: keco@optonline.net Website: www.kecocontrols.com