Casters Application Worksheet


Basic Contact Information:
Name:
Company:
Address:
State:
Zip:
Phone:
E-Mail:
Best Time to Call:


Caster Information:
Briefly Describe your Application:
What is your caster requirement?


If Replacement:
What Brand is it?
What model is it?


If Unknown:
Wheel Material:
Wheel Diameter:
Top Plate Size:
Bolt Hole Spacing:
Height:


If Stem Mount:
Size:
Diameter:
Length:
Thread:


Any Unusual Environmental Conditions:
Chemicals (List, if any)
Water/Water Vapor:
Load Capacity Required (per caster):
Temperature:


Equipment Caster Requirements:
Swivels:
Rigid:
Wheel Only:
Floor Surface:
Floor Type:
Is Noise a Factor?
How Will This Equipment be Moved?
At What speed will it be moved?
Options
If other, please Specify