Company:
Date:
Name:
Title:
Address:
City :
State:
Zip Code:
Telephone:
Fax:
email:

General Specifications

Application:
Material:
Machine Manufacturer:
Model:
Maximum Load (core shaft weight + roll weight) =
Maximum Working Speed: RPM
Maximum Transmissible Torque: ft.#

Drive Shaft Details

A =
B =
C =
D =

Keyway Size:
       Width of keyway:
       Depth of keyway:

Chuck Requirements

Jaw insert type:
        Square Turned 45     Circular         Triangle

Removeable jaw insert?: Yes    No

Sidelay adjustment?: Yes    No
      If yes, 2" or   4"

Mounting:
       Flange Foot

Options needed:
     Air Operation
     Rotary Table for Baggy Edge Adjustment
     Sidelay chuck with fixed drive shaft

Present Safety Chucks

Manufacturer:
Type and/or model number:

Problems and/or other notes: