Applied Sensor, Division of United Electric Controls
Application Checklist Form
Please Select Your Sensor Requirements and Submit for Technical Assistance

Required Fields *
Customer Information

  Full Name
  *

  Company Name
*

  Address 1
  *

  Address 2

  City
  *

  State
*

  Zip Code/Postal Code
 

  Country
*  

  Phone Number
  *

  Email Address

  Fax Number
  *

Temperature Sensor Information

  >   

Select One:
    Thermcouple     Calibration

       Junction  
Grounded
Ungrounded
Exposed
   
 
RTD:   

Reference

 Tolerance

 Construction
 
Thermistor:   

Reference

 Tolerance (%)
Other:   

Specify

    

Physical Characteristics
Sheath Length

 Sheath Material

 Sheath O.D.
Leadwire Styles      Length Inches

 Wire Type

 Termination
Terminal Head Style      Head Type

 Material

 Process Connection

Other      Specify
Environmental Characteristics
Working Media Air    Inert Gas    Water    Other    Specify   
Working Ambient Temperature Min    Max    °C    °F   
Measured Temperature Min    Max    °C    °F   
Vibration      (Specify)
Shock           (Specify)
Other            (Specify)

Installation Location
Indoor    Outdoor    Protected    Unprotected   
Options
Thermowell

   (specify)
Transmitter

   (specify)
Other

   (specify)