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To build a file on your company and specific requirements, to ensure a quality product to your exact specifications please complete the following informational questionnaire.

The items in bold type are of special importance.
PARTICULARS OF MACHINE
   
Owner of Machine:
Contact Name:

Company Phone Number:

Company Fax Number:
E-mail address:

Address:
State/Province:
Zip:

Country:

Manufacturer of Machine:
Type of Service:
Is the Machine a:
      
 Motor
Generator
Exciter 
 Other:
Manufacturer's Type:
    
Serial Number:
Does the machine run in one direction only? 
Yes   No
Owner's Machine Identification Number:
D.C PARTICULARS
Voltage:
H.P or K.W Rating:
Full Load capacity of machine amperes:
Amount and approximation duration of overload:
Revolutions per minute:
Does the machine operate in chemical fumes? If so, of what nature?
Diameter of commutator:
Number of segments:
Is the mica cut?
Yes No
Number of main poles:
Number of interpoles?
Do the brushes operate: 
Leading Trailing Radial
If leading or trailing operation, state angle:
Total number of brushes on the machine:
Size:
Length:
Width:
Thickness:
Grade of brush used at present:
What, if any, trouble has been experienced:
SLIP RING PARTICULARS
What metal are the rings composed of:
Number of rings:
Diameter of rings:
Width of rings:
Revolutions per minute:
Amperes per ring:
Total number of brushes per ring:
Size: 
 Length:
Width:
Thickness:
Are the rings enclosed? 
 Yes No
If an induction motor, are the brushes lifted when motor has run up to speed?
 Yes No
Grade of brush used at present:

Select style of brush from sketches on Brush Styles page.
Fill in dimensions requested on the Brush Ordering Procedure page.