E3 Modulevel® Application Questionnaire (Please complete all applicable pages.) REFERENCE INFORMATION Customer/Company: City, State, Country: SIC: Date: Contact/Title: Phone: Fax: RFQ Number: E-mail: P. O. Number: FOR OFFICE USE: Tag Number(s): Submitted by: Rep Agency and Salesperson Rep Code: PROCESS DATA Process Name/Description: Process Media: * Interface: c Yes c No Varies c No Specific gravity of lower material: c Yes, from to * Displacer must be completely submerged for interface applications. Varies c No Media: Specific gravity: Special Levels: c Yes c No c AMB Process Temperature: c ATMOS Process Pressure: Temperature at Instrument: c AMB Steam present: c Yes Environment: c Normal Agency: c FM c No c CSA c Corrosive min. max. min. max. min. max. c Salt c ATEX EEx c IEC Area Classification: c General Purpose (Nema 4X) Hazardous Area Design: c Explosion-proof c°F c°C c Other c°F c°C c Other c PSIG c Hazardous: Cl c No to c Bar c KPA c Other c Flood c Intrinsically Safe Remote Instrument (if applicable): c Yes c Yes, from Div Group c Non-Incendive c SIL 2 c Other Length required: Required Materials of Construction: Vessel Type: c Vertical Cylindrical c Sphere Vessel Size: Height Type of Filling: c Top Liquid Surface: c Calm Agitation: c No c Yes Width c Bottom Output: c HART Analog c Yes c O.C.F. c Other Diameter c Side (At what level? c Moderate Turbulence Other Objects in Vessel: c No ® c Sump/Pit c Vortex Unit of Measure ) c Flowing (Include sketch on page 2) c FOUNDATION fieldbus Special flange type: c Fisher ™ c Masoneilan c Other (Please describe) INSTRUMENT Model Number: E 3 Quantity: Notes: 1. Please see page 3 for torque tube replacement. 2. Customer is responsible for material compatibility. BULLETIN: 48-352.1 VESSEL SKETCHES Inches E3A/E3B mm Side/Bottom Flange to Top of Displacer Overall Length Level Range Level Range Side/Side Level Range BULLETIN: 48-352.1 FOR TORQUE TUBE REPLACEMENT Confirm Flange and Dimensions: Fisher 249 B/259 B (600 lb.) carbon steel (Figure 1 below) Masoneilan (Figure 2 below) ANSI – Size: Pressure Class: 3" 4" 6" 300# 150# 600# 900# 1500# 2500# Other ________________________________ Ø 9.0 (229) Ø 7.50 (191) Ø 7.25 (184) Ø 5.875 (149) 45° 45° Ø .875 (22) Ø .875 (22) 1.125 (29) 1.125 (32) 5.23 (133) 4.00 (102) .22 (6) .25 (6) Fisher 249B/259B (600 lb.), carbon steel Masoneilan (600 lb.), carbon steel Figure 1 Figure 2 Confirm chamber ID: ______________________ ID L Distance (L) from top of chamber to upper process connection: ______________________ Maximum measuring range: ______________________ Measuring Range Side/Bottom Internal depth of chamber: _____________________ Internal Depth of Chamber Measuring Range Side/Side 705 Enterprise Street • Aurora, Illinois 60504-8149 • 630-969-4000 • Fax 630-969-9489 [email protected] • www.magnetrol.com 2" standard distance between bottom of displacer and internal bottom of chamber BULLETIN: 48-352.1 EFFECTIVE: March 2015 SUPERSEDES: August 2014