DISTRIBUTOR:
SITE:
CONVEYOR NUMBER:
ROLL MANUFACTURER:
FRAME MANUFACTURER:
BELT WIDTH:
IN.
MM
BELT SPEED:
TONS PER HOUR:
SITE CONTACT NAME:
SITE NUMBER:
ROLL PERFORMANCE INTEREST:
Are you sending in a roll for measurement?
Yes
No
Do you need rolls back?
Yes
No
If yes, where?
WEAR LIFE
NOISE
WEIGHT
RECYCLABILITY
POWER CONSUMPTION
CORROSION
ROLL LOCATION: (Select one)
EQUAL TROUGH
CENTER TROUGH
WING TROUGH
FLAT RETURN
VEE RETURN
ROLL CEMA RATING: (Select one)
B
C
D
E
F
FRAME TROUGHING ANGLE: (Select one)
20%
35%
45%
OTHER
ROLLER OPERATING TEMPERATURE RANGE
Less than
-22°F (-30°C)
Between -22°F (-30°C)
and 140°F (60°C)
Above
140°F (60°C)
SPACING BETWEEN FRAMES
MATERIAL CONVEYED
LENGTH OF TRIAL/TEST
ROLL QUANTITY
SHAFT END DETAILS—TYPE: (Select one)
A
B
C
D
F
G
H
J
K
L
DIMENSIONS
INCHES
MILLIMETERS
F
G
H
I
J
NOTES