OmegaFlex®
Hose Application Specifier
Date

Company

 Contact
Address
Phone
Fax
Email

SIZE
I.D.

 O.D. Overall Length
TEMPERATURE
Operating°FDesign°FExcursion°FExternal°F
APPLICATION
Motion:
Lateral One Side of CenterlineOther Side of Centerline
Angular One Side of CenterlineOther Side of Centerline
Motion FrequencyCycles per

Assembly Drawing

Velocity: Ft./Sec.
Assembly Configuration: Hose Straight Dogleg Jacketed/Duplex

Vertical Loops Horizontal Loop

Define Dogleg Lengths
Liner Required   Yes No Liner Material
Cover Required Yes No Cover Material
MEDIA
Internal Flow Media
External Environment Corrosives
Hose Material Braid Material
Braid Layers 0 1 2
PRESSURE
Working Pressurepsig		 Test Pressurepsig VacuumHg
Pressure Type Constant Shock Pulsating Intermittent
Define shock or pulsating pressure
External Pressurepsig Atmospheric
END FITTINGS
Fitting #1:Size		 Type Material
Fitting #2:Size Type Material
Pipe schedule, wall thickness or pressure rating
DELIVERY
Quantity 		Required Ship Date

Print , complete and mail or fax to:

OMEGAFLEX®, Inc.
451 Creamery Way, Exton, PA 19341-2509
Tel: 1-610-524-7272   Fax: 1-610-524-7282

W-specform-0900