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Cosense Inc.
155 Ricefield Lane
Hauppauge, NY 11788-2007
Phone No. 631-231-0735
Fax No. 631-231-0838

APPLICATIOIN QUESTIONNAIRE
AIR BUBBLE/AIR-IN-LINE/LIQUID LEVEL
AD-101 SERIES

Rep Name:
Customer:
Address:
City, State, Zip:

Date:
Phone:
Fax:
Email:

Number of Units to be quoted:

Potential number of units:

Delivery Expected:

Prototype at no charge, if number of units exceeds 100.

TUBING/DRIP CHAMBER
1.	Tube/Drip Chamber ID with Tolerance
2.	Tube/Drip Chamber OD with Tolerance
3.	Tube/Drip Chamber Material
4.	Tube/Drip Chamber Durometer
5.	Type of Liquid
6.	Temperature Range
7.	Flow Range
8.	Sensor mechanical dimensions/form factor envelope if cutomer has tight space.
9.	Sensor mounting arrangement (if any special req.)
10.	Electronics Integral/Remote
11.	Remote: Specify Length of wire
12.	Input Power: 5VDC, 12VDC, 15VDC, 24VDC
13.	Output:	a) Electrical: CMOS, TTL, Open Collector, Source Current, Sink Current, 1 AMP Dry Relay Contact
		b) Timing: Pulse output function of air bubble
		Fixed pulse width
		Duty cycle type
		RS232
14.	Response Time: Detection of an air-bubble and back to liquid state
15.	Air-Bubble Size: Minimum if customer has specifications
16.	Larger tube/pipe size from 1" (25mm) to 12" (300mm) refer to SE-600 Series.
17.	Special Call 1-800-456-9994/email:sales@cosense.com