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10037-96 Avenue

Westlock, Alberta

Canada T7P 2P9

P: 780.349.6511

F: 780.349.4232

CustomManifold

Quote Request Form

Please return completed form by email to

info@customtee.com

or by fax to 780.349.4232.

Contact Name:

Company

:

Phone:

Email:

Description of Application:

All sizes listed below are CTS. All product is type L copper.

Please circle your selection from each of the following categories.

Leaders in Custom Manufacturing Since 1989

Header Size:

1”

1-1/4”

1-1/2”

2”

2-1/2”

3”

4”

6”

End #1 Size:

1/2”

3/4”

1”

1-1/4”

1-1/2”

2”

2-1/2”

3”

4”

6”

End #2 Size:

1/2”

3/4”

1”

1-1/4”

1-1/2”

2”

2-1/2”

3”

4”

6”

No. of Branches: _________

Branch Size:

1/2”

3/4”

1”

1-1/4”

1-1/2”

2”

2-1/2”

3”

4”

6”

Branch Type:

Male Sweat

Female Sweat

MIP Thread

FIP Thread

F1807

F2080

Viega PEX Press

TM

Branch Options

No Valves

Valves*

Branch Centers: _________

*All valves are left inlet

unless otherwise

specified.

End #1 Type:

Male Sweat

Female Sweat

MIP Thread

FIP Thread

F1807

F2080

Viega PEX Press

TM

Closed

End #2 Type:

Male Sweat

Female Sweat

MIP Thread

FIP Thread

F1807

F2080

Viega PEX Press

TM

Closed

Quantity: _______________