Pump Repair Sheet

Tag #:__________________________________________ Notes:___________________________________________________

Location: _______________________________________ _________________________________________________________

Manufacture: ____________________________________ _________________________________________________________

Model#: ________________________________________ _________________________________________________________
Size: ___________________________________________
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Serial#:_________________________________________
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Coupling Brand & Size: ___________________________
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IB Bearing#:_____________________________________
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IB Seal#:________________________________________
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OB Bearing#:____________________________________
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OB Seal#:_______________________________________
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Packing Size & Quantity: __________________________
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Mech. Seal Size & #:______________________________

Shaft Sleeve#:____________________________________ _________________________________________________________

Shaft#: _________________________________________ _________________________________________________________

Impeller Size & Vanes: ____________________________ _________________________________________________________

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Rebuilt By: ______________________________________ _________________________________________________________

Date: ___________________________________________ _________________________________________________________