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PARJET CO., LTD.
ENGINEERING DESIGN REQUEST FORM

*Company:
Division:
Address:
Zip Code:
*Contact Person:
*Contact Number:
*E-mail:
Fax:
Application:
Current Seal:
P/N:
Newly-designed Seal:
Annual Usage:
Quote Quantity:
Problem(s) with Current Seal:
Silicon Filled (FDA available):
Seal Motion:
Seal Type:
System Pressure:
RPM:
Rotation:
Stroke Length:
Velocity:
System Pressure:
Pressure Direction:
Temperature:
Media:
  • A
    A B C D
  • B
    A B C D E
  • C
    A B C
  • D
    A B C
*Verification: