Company:

Contact Person:

Street:

ZIP-code/City:

Telephone:

Telefax:

eMail:

Analysis of Operating Conditions

inside

outside

both

ground conditions good

ground conditions
medium

ground conditions bad

Door Frame Clearance (Width x Height):

mm  x

mm

Ascent (Height / Length):

mm  /

mm =

%

Battery:

yes

no

Operating Hours/Day:

h

No. of shifts:

1-shift operation

2-shift operation

3-shift operation

Aquamatic:

yes

no

option

Battery Request:

Battery Charging Unit:

yes

no

Battery Charging Time:

h

Equipment

Miscellaneous

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