Reversing Valve Product Request Form

Name

Company

Email Address

Phone Number

Comment

Refrigerant Type

Capacity (Tons)

Inlet Tube Size

Outlet Tube Size

Tube Style(Straight/Straight Candy Cane/Flare/Flare Candy Cane/Offset Straight/Offset Flare)

Coil Rating

Coil Connection(Wire Lead/Quick Connect)

Wire Lead Length

Current Supplier

Current Supplier Part Number

EAU(Estimated Annual Usage)