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Pressure
Gauges
Series 34 Pressure Gauge
InSight Series 34 Pressure Gauge
Series 25 Pressure Gauge
Stainless Steel Gauges
Switch Gauges
Skydrol Gauges
Precision Test Gauges
OEM Custom
Gauges/Hoses
Custom Pressure Gauges
Custom Hose Assemblies
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Gauge Accessories
GP140 Series Diaphram
GP400/500 Series Isolator
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Controller/Hand Pumps
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and Gas Boosters
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Custom Product Request Form
Custom Product Request Form
2900 E. White Star Ave.
Anaheim, CA 92806
Phone: 714-399-9200
Custom Product Request Form
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Customer Info
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Name
*
Phone
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Email
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ITAR?
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3D / WIKA Sales Info
Name
*
Phone
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Email
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Date of Inquiry
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Application/Description of Product
*
Business Case
Est. Annual Qty
*
First Delivery
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Target Price
*
MOQ
*
Technical Characteristics
Gauge Size
*
Operating Pressure
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Accuracy
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Samples
Samples Request?
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If Yes, QTY Req'd
If Yes, Date Needed
Specific Testing Requirements (If Applicable)
Additional Information (Req'd if NO Drawing)
Scale Arc
Case Shape
Case Outside Dia.
Case Depth
Case Material
Case Mounting
Fitting Thread Spec
Fitting Location
Fitting Material
Fitting Length
Wrench Flats
Bourdon Tube Mat'l
Lens Material
Blowout Loc.
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