<p> In order to design your Bal Seal Canted Coil Spring® solution, we need to know more about your application requirements. Please complete this form and e-mail it to us at [email protected], or fax it to (949) 460-2300. Name: Date: Company: Title: Address: Department: City, State & Zip: Telephone: E-mail: Fax: Product data: Service:</p><p>Equipment type: Static Dynamic Application is used for: Application type (Please check all that apply): Prototype Holding Electrical User undefined Production Latching EMI Shielding Garter Retrofit Locking Isolating Thermal Other: Loading Pre-load Annual usage: Target price (per unit): Other: Media type : </p><p>Mechanical application conditions: Electrical application conditions: Operating temp.: ºC ºF ºK Continuous current: A kA Allowable Increase: ºC ºF ºK Short circuit current: A kA Number of cycles: Short circuit duration Stroke length: Inches mm (seconds): Insertion force: Grams Lbs. N Resistance: Ohms Removal force: Grams Lbs. N Micro ohms Sliding force: Grams Lbs. N Other: Compression force: Grams Lbs. N Dimensional information: Housing information: Inches Tolerance Can be Material: mm (+/-) modified Plating/coating: Piston diameter (PD): Hardness (Rc): Piston groove diameter Surface finish: RMS Ra (PGD): Piston information: Housing bore diameter Material: (HBD): Plating/coating: Housing groove Hardness (Rc): diameter (HGD): Surface finish: RMS Ra Housing outer diameter Special requirements: (HOD): (Please check all that apply) Groove width (GW): DFARS ITAR Groove depth (GD): FDA Compatible Passivation Inner diameter (ID): Biocompatible/implantable Length: Spring plating Gold Gap: (check type) Silver Nickel Tin Gland configurations: Piston mounted Housing mounted Face mounted Cut-to length</p><p>Rev. 06/28/12 Bal Seal Engineering, Inc.: 19650 Pauling  Foothill Ranch, CA 92610-2610  Tel: (949) 460-2100  Fax: (949) 460-2300 Bal Seal Engineering Europe B.V.: Jollemanhof 16, 5th floor  1019 GW Amsterdam  The Netherlands  Telephone: 31 20 638 65 23  Fax: 31 20 625 60 18 Bal Seal Asia Limited: Suite 901, Chinachem Century Tower 178 Gloucester Road, Wanchai, Hong Kong  Telephone: +(852) 28681860  Fax: +(852) 22956753 Page 1 of 1</p>