Industrial Driveshafts
Application Data Form

Driveline Service of Portland requires the following information to properly select your driveshaft. Please complete as much of the form below as is known or applicable at present. Our staff will contact you to determine any other necessary information.


Full Name:
Phone:
E-mail:
List me as: an individual
a business
Company:
Address:
City:
State:
Zip:
Fax:


Project reference:  
Type of application:  
Power source: DC electric AC electric Diesel
  Gas Other (describe)

Motor horsepower: At What RPM:
Maximum overload motor output:    
Torsional coupling between motor and driveshaft:   Yes No  
Gear reduction between motor and driveshaft:   Yes No Ratio:
Driveshaft speed:    
Distance between input and output shafts:    

Horizontal offset of shafts:   Distance: Degrees:
Vertical offset of shafts:   Distance: Degrees:
Type of load: Continuous Reversing Alternating

Anticipated operation, annually:   hours  

Additional Comments:
   

Call Us Toll-Free: 800-227-8608
Email Us:info@driveshafts.com
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