Metal Industry 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  
Motor horsepower: At what RPM:
Maximum overload motor output:  
Type of load: Continuous Reversing Alternating

Number of driveshafts driven by motor:    

Gear reduction between motor and driveshaft:   Yes No Ratio:
Driveshaft speed:    

Distance between output and input shafts:    
Horizontal offset of shafts:   Distance: Degrees:
Vertical offset of shafts:   Distance: Degrees:

Pinion shaft diameter:   Roll shaft diameter:
Minimum centerline of pinion shafts:      
Maximum centerline of pinion shafts:    

Anticipated operation, annually:   hours  
 
Additional Comments:
   

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