QUESTIONNAIRE FORM
To apply for an Altronic GTI Bi-Fuel System quote please complete all questions to the best of your ability. A consultant will get back to you within 24 hours.
Name
First Name
Last Name
What is the engine make?
What is the engine model?
What is the tier rating?
No Tier
Tier 2
Tier 3
Tier 4 Interim
Tier 4 Final
How many combustion air intake filters?
How many primary turbo chargers?
0
1
2
4
6
Other
What is the diameter or circumference of the inlet pipe size at the mixer installation location between the turbo charger and air filter?
Does the engine have any of the below?
Variable Geometry Turbo
Wastegate
Exhaust Gas Recirculation
None
How many intake manifolds?
1
2
4
Other
How many manifold circuits do you have on the engine?
1
2
4
Other
Which is the engine?
2 Stroke
4 Stroke
What is your engine RPM?
1800
1500
1200
1000
900
750
Other
Engine configuration:
In-Line
In-V
Other
Does engine have a “Full Authority” governor?
Yes
No
Is real time fuel consumption data available on the engine?
Yes
No
What is the power pack configuration?
Gen Set
Pump Set
Other
What is the generator hertz rating?
What is the generator voltage rating?
What is the generator current rating?
What is the power factor rating?
Pump Type:
Centrifugal
Reciprocating
Rotary
Other
What is the power pack duty cycle rating as per data plate?
Continuous
Prime
Standby
What is your power pack rating number?
Type:
KW
MW
HP
What is maximum actual load requirement at installation?
Type:
KW
MW
HP
Gas source:
Pipeline NG
LPG
Other
STANDARD GTI SYSTEMS: Will gas supply maintain 5–50mbar and flow of 8 scfh x per KW?
Yes
No
Other
GTI+ APPLICATIONS ONLY: Will gas supply maintain 3–15psig and flow of 8 scfh x per KW?
Yes
No
Other
Business Name
First Name
Last Name
Who were you referred by?
E-mail
example@example.com
Business Number
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
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Algeria
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Armenia
Aruba
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Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
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Cameroon
Canada
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Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
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Cote d'Ivoire
Croatia
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Curaçao
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Dominican Republic
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Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
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Grenada
Guadeloupe
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Iraq
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Israel
Italy
Jamaica
Japan
Jersey
Jordan
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Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
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Seychelles
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Slovenia
Solomon Islands
Somalia
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South Ossetia
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eSwatini
Sweden
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Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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