1. Please describe your application or problem:

2. Floor Surfaces and Conditions

A. Floor Surface:
Asphalt Brick Concrete Steel Hardwood Carpet Gravel
Other (Describe):

B. Floor Surface Irregularities:
Metal Scraps Water Threads Fiberglass Oil

C. Adverse Conditions:
Excessive Heat: °F How Long? minutes
Excessive Cold: °F How Long? minutes

3. Load Capacity and Equipment Evaluation

A. Maximum load on unit: (lbs.) Number of caster per unit:
B. Total weight of unit: (lbs.) Number of units:
C. Total load capacity: (Sum of A (lbs.) + B (lbs.)
D. Overall size of unit: (length)   X   (width)   X   (height)
E. Will unit transport or carry people? Yes   No
F. Will unit be subject to shock loading? Yes   No
G. Will unit be power towed? Yes   No
If so, what speed? MPH

4. Special Requirements

A. Caster height limitations (inches)
B. Top plate size (length)   X   (width)
Mounting hole spacing (length)   X   (width)
C. Wheel brake required? Yes   No
Swivel lock? Yes   No
D. Sanitary (NSF) application? Yes   No
E. Stem mounting required? Yes   No
If so, please specify:
Threaded Stem: Size (threads per inch) (length)
Tubular Mount: Gauge of tubing (ga.) (inside diameter)

5. Contact Information