1.TYPE OF APPLICATION

		Equipment the Kerry Actuator is to operate: (flop gate, slide gate, butterfly valve, damper, carriage, side guides, etc)
		Size of device:
		Linear or Rotary Applicaion:  Linear Rotary

2. PHYSICAL DATA

	A.	Force Required
		Pounds Push (Extend):		-Or-	Inches/ lbs. Torque (CW)
		Pounds Pull (Retract):		-Or-	Inches/ lbs. Torque (CCW)

	B.	Stroke (in inches):		-Or-	Total Rotation (deg):

	C.	Speed or duration of movement (inches or degrees/sec)
		Extend/CW speed:
		Retract/CCW speed:

	D.	Total time for one stroke or rotation (seconds)
		Extend/CW time:
		Retract/CCW time:

	E.	Negative Load (please choose one)
		No    Yes
		Extend
		Retract

	F.	Orientation of Unit
		Horiz.   Vert.
		If Vertical then choose:  Rod/Shaft Up    Rod/Shaft Down

3. FREQUENCY OF MOVEMENTS

		Number of complete cycles
		Per Hour:		Per Day:

4. ABSOLUTE LOCK IN POSITION

		No    Yes
		Duration:

5. MOUNTING

		Rod End:
		Male Clevis  Threaded    Female Clevis    Spherical eye    Keyway    Splined
		Other (specify):
		Body Mount By:
		Trunnion     Foot     Eye to eye     Front Flange
		Other (specify):

6. POWER SUPPLY

		Voltage:		Frequency:
		Phases:		Enclosure:

7. SURROUNDING CONDITIONS

		Outdoor     Indoor
		Shocks/vibrations:  mild     moderate     severe     none

8. ACCESSORIES

		Please check any that apply
		Trunnion Brackets
		Limit Switch______No. positions:       No. contacts:
		Position Feedback_____ Type:
		Accumulator (if fail safe)_____Extend or CW:     Retract or CCW:
		MPO-1Q Manual Pump        Built in:      Detachable:
		Position Controller
		Motor Starter Panel ____  Elec. const.
		Other:

9. ADDITIONAL COMMENTS