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To receive your quality sealing solutions from Acuseal, please fill up the form or dowload the PDF document below, or if you have any questions, please call us toll-free at 1-800-ACUSEAL. Thank you for your request.
 
Click here to download the worksheet  
 
 
Customer Information:
Name: Title:
Company: Address:
City: State:
Zip:    
Phone: Fax:
Application/Type of Equipment:
Present Seal:
 
Customer Information:
Static Dynamic Reciprocating Oscillatory
Rotary Single Acting Double Acting
     
Temperature: Pressure:
Stroke: Cycle:
R.P.M.: Speed:
SideLoad:    
 
Hardware:
Gland Design
Piston Design
Wiper Snap In (Type : )
  Press Fit (Bore : , Recess : )
Wear Ring
Required Not Required    
     
Description MM/Inch Material
Bore Diameter
Rod Diameter
Groove Diameter
Piston Diameter
Groove Width
 
Problem with present seal:
Delivery Installation Dimensional Quality Others (please explain):


Short Life Excessive Wear Price
Material Failure Excessive Leakage Supplier Service
Notes:
 
 
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