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1801 Falls Ave. Waterloo, IA 50701
319-233-6101
Home
About
Safety
Services
Boiler Systems
Gas Fired Equipment
Certified Welding Services
Process Piping
Pump Services
Certified Backflow Testing
Inspections
Parts
Careers
Contact
Warranty Consideration
Warranty Consideration
Use this form to request warranty consideration.
Step
1
of
8
12%
Employee Name
(Required)
Delivery Type
(Required)
Select One
Regular Delivery
Overnight Delivery
Job Type
Select One
New Job
Current Job
Job #
(Required)
Customer
(Required)
Job Location
(Required)
Contact Name
(Required)
Contact Phone
(Required)
Contact customer with pricing information?
(Required)
Yes
No
Description of Work or Parts Needed
(Required)
Describe the issue(s) with the part
(Required)
Equipment Information
Equipment Manufacturer
Equipment Model Number
Equipment Serial Number
Upload Photos
Please provide photos and comments as needed to help identify system and parts.
Multiple files can be uploaded.
Drop files here or
Select files
Max. file size: 15 MB.
Multiple files can be uploaded.
Picture Comments
Operating System
System Type
Select One
Steam
Hot Water
Air
Gas
Oil
Other - See Notes
Pressure Unit
Select One
PSI
inches
CFM
Gallons
Other - See Notes
Maximum System Pressure
Operating Pressure
Operating Pressure
Relief Valve - MFG
Relief Valve - Model #
Relief Valve - Inlet Size
Relief Valve - Outlet Size
Relief Valve - Units
Select One
lbs/hr
BTU/hr
SCFM
gallons/min
Other - See Notes
Operating System Notes
Motor Information
Motor Manufacturer
Motor Serial Number
Motor Model Number
Voltage
Select One
24
110
208
220
240
Other - See Notes
Phase
Select One
1
3
Horsepower
Select One
1/16
1/4
1/3
1/2
1
1.5
2
3
4
Other - See Notes
RPM
Select One
1724
3450
Other - See Notes
Frame
Motor Notes
Pump Information
Pump Manufacturer
Pump Model Number
Pump Serial Number
GPM
Pump PO #
Feet of Head (PSI)
Pump Inlet Size (inches)
Pump Discharge Size (inches)
System Pipe Size (inches)
Pump Notes
Any additional parts/equipment/components necessary to install the part being requested?
(Required)
Δ
