Application Worksheet


Please fill in the following information for the proper sizing recommendation for your application. If there are multiple machines, fill out one for each machine. If there are multiple motors on a machine, we need the info on the individual motors, start sequence, and function of each motor. Print it out and fax it back to 661-947-8764.

 

YOUR NAME:_________________________

 

YOUR PHONE#:_________________

YOUR FAX#:_________________________ YOUR EMAIL:___________________
YOUR ADDRESS:_____________________ CITY:__________________________
STATE:_____________________________ COUNTRY:_____________________
TYPE OF EQUIPMENT (lathe, pump, mill, etc.):_____________________________________
MACHINE BRAND (not motor):_______________ MACHINE MODEL #:__________________
COUNTRY OF MFR. : Of machine: ___________________      Of motor: _______________
NAMEPLATE RATINGS: Voltage: ________ Amperage rating:________  RPM: ________
HORSEPOWER:_________                                 KW: __________                                KVA: ___________
SINGLE-PHASE VOLTAGE AVAILABLE:   220V_____          440V______       60HZ____      50HZ____    
3-PHASE VOLTAGE REQUIRED: (220V, 380V, 440V, 575V)_____       60HZ____      50HZ____ 
PERCENT OF OUTPUT REQUIRED:     1-67% ____                68-100% ____
DOES THIS HAVE A HEAVY STARTING LOAD?  Yes ____                No ____
DOES THE MACHINE STALL OUT?    Yes ____                      No ____
DOES THIS START FREQUENTLY?  Yes ____                  No ____
DOES THIS INSTANT REVERSE?    Yes ____                No ____
IS THIS BELT DRIVE?  ____                   DIRECT DRIVE?  _____
DOES THIS HAVE A FLYWHEEL? ______      HYDRAULIC PUMP? ______       NEITHER? _____
IS MOTOR:   Wye-wound? ____              Delta-wound? ____
3-PHASE POWER REQUIRED MUST BE:   Wye _____    Delta _____    Doesn't matter _____
ARE THERE 3-PHASE CNC OR OTHER ELECTRONIC CONTROLS (rheostat, variable frequency drive, SCR, dynamic braking, etc.) THAT ARE:  Single-phase _____         3-phase _____
DOES THE MACHINE HAVE REGENERATIVE BRAKING?   Yes _____                No _____
DOES THE MACHINE HAVE 3-PHASE HEATING ELEMENTS?   Yes _____                No _____
REMARKS:______________________________________________________________
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PHASE-A-MATIC, INC.
39450 3RD ST. E., SUITE 127
PALMDALE, CA. 93550-3251