Please provide the following contact information:
First name Last name Title Organization Work Phone FAX E-mail
Date : -- mm/dd/yy
Make and Model of the crane:
Type: (lattice boom, box boom, telescoping...)
Lines and blocks to be monitored:
Main Jib Other
Line size and Maximum single line pull for each block:
Diameter of hole in Pad Eye/Wedge Socket
Main- Jib- Other-
Parts of line operation on each block (Even = 2-4-6-etc. Odd = 1-3-5-etc)
Power available:
12VDC 24VDC 115VAC 240VAC Other
Does the crane have a cab?
Yes No
Is cab raised?
Yes No If so, how many feet? FT
Additional special requirements or comments:
add special comments here
Be patient while form is sent.