Straight Evaluation Form (Imperial)

This form helps you to create the optimal design for your conveying needs.

By submitting the evaluation form, Intralox will do a free analysis of your design. An Intralox Technical Support representative will contact you to discuss your design and recommend the best belt for the intended purpose.

The fields indicated with an asterisk (*) are required.

Personal Info Name*   Title* Phone* Country code + Area code + Phone number  -  -   E-mail* Company Name*   Country* --Country-- Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cameroon Canada Cape Verde Central African Republic Chad Chile China Colombia Comoros Congo (Brazzaville) Congo, Democratic Republic of the Costa Rica Croatia Cuba Cyprus Czech Republic Cote dIvoire Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Finland France Gabon Gambia, The Georgia Germany Ghana Greece Grenada Guatemala Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Korea, South Kuwait Kyrgyzstan Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Mali Malta Mauritania Mauritius Mexico Moldova Monaco Mongolia Morocco Mozambique Namibia Nauru Netherlands New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Panama Paraguay Peru Philippines Poland Portugal Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and The Grenadines San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Somalia South Africa Spain Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Trinidad and Tobago Tunisia Turkey Turkmenistan Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vatican City Venezuela Vietnam Western Sahara Zambia Zimbabwe Address*   City* State/Province Zip/Postal       Belt & Sprocket Information Series*: -Select- Style*: -Select-   Material*: -Select- Intralox Recommendation Polypropylene Polyethylene Polyacetal Electrically Conductive FDA Nylon Non-FDA Nylon Flame Retardant Polypropylene Composite Detectable Polypropylene   Width*:  in Length(centerline to centerline)*:  ft Finger Transfer Plates: Yes No Flights*: Yes No Flight Height:  in Flight Spacing:  in Sideguards*: Yes No Sidegaurd Height:  in Sprocket Pitch Diameter*:  in Bore*:  in Shaft Material*: -Select- Carbon Steel 303/304 Stainless Steel 316 Stainless Steel   Journal Diameter*:  in   Product Information ( Product Being Conveyed)   Plastic Aluminum Steel Cardboard Glass Sharp Dry Wet Slippery Frozen Sticky Raw Fresh Cooked Sauce Marinade Crumbly Seasoning Abrasive Corrosive FDA Req'd USDA-FSIS Req'd Other if other please specify: Product Load*:  -Select- Total Load lbs Total Load kgs lbs sq/ft kg sq/m   Product Description*:   Product Size: in wide    in long  in height Product Spacing:  in                            Individual Product Weight:  lbs kg oz grams   Product Temperature:  f Method of Loading: End to End Side Top Impact Manual     Application Data Belt Speed*:  fpm Temperature @ Drive*:  f Carryway Construction*: Parallel Chevron Solid Other if other (please specify):   Carryway Conditions*: Wet Dry Abrasive Carryway Material*: UHMW HDPE Nylon Steel Other if other (please specify): Nosebar*: None Static Dynamic Material of Nosebar: UHMW Steel Other if other (please specify): Accumulation*: Yes No if yes (percent of accumulation):  % Drive Location*: -Select- Discharge Center Drive Infeed Other if other (please specify): Frequent Starts and Stops*: Yes No Elevation Change*: Horizontal Incline Decline   ft  Sanitation Method of Cleaning :   Frequency:   Cleaning Chemicals:   Concentration: % Temperature of Cleaning Media: Time Belt Exposed:       Additional Comments   Would you like to attach a drawing? *Attachment must be ".pdf",".doc",".docx",".jpg" or ".xls" in lowercase and less than 3MB.