GenMar Altronic GTI Bi-Fuel System Questionnaire Form

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 NameLast Name
What is the engine make?
What is the engine model?
No TierTier 2Tier 3Tier 4 InterimTier 4 Final
How many combustion air intake filters?
01246Other
What is the diameter or circumference of the inlet pipe size at the mixer installation location between the turbo charger and air filter?
Variable Geometry TurboWastegateExhaust Gas RecirculationNone
124Other
124Other
2 Stroke4 Stroke
1800150012001000900750Other
In-LineIn-VOther
YesNo
YesNo
Gen SetPump SetOther
What is the generator hertz rating?
What is the generator voltage rating?
What is the generator current rating?
What is the power factor rating?
CentrifugalReciprocatingRotaryOther
ContinuousPrimeStandby
What is your power pack rating number?
KWMWHP
What is maximum actual load requirement at installation?
KWMWHP
Pipeline NGLPGOther
YesNoOther
YesNoOther
Business Name

First NameLast Name
Who were you referred by?
E-mail
example@example.com
Business Number
Format: (000) 000-0000.
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

QUESTIONNAIRE FORM