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Medical Questionnaire

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Medical Chiller Questionnaire

Name

Company

City

Website

Type of Process being Cooled

Equipment Manufacture and Model Number

City Water Switch Over Required

Air Compressor and Refrigerated Air Drier Required

Coolant Flow Rate

System Pressure

Required Fluid Temperature

Required Water Temperature

Batches per Hour

Make up Water Temp. Max

Volts

Phase

Type of Condenser

Chiller Location

Please Describe Ambient Conditions

Notes/Comments

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Name

Phone

Company

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