Temperature        
Operation Frequency        
Valves Replaced. Please state type,  
manufacturer and reason for
replacement.
Please describe estimated order date
and required delivery date.
Copeland Industries
6841 Ave U
Houston, TX  77011

Ph. 713-926-7481
Fax: 713-926-9806
email: copeland@copelandballvalves.com
About Privacy

Your privacy is important to Copeland Industries, Inc., as is your trust in our products and services. We want
you to know that the information we collect will be treated with care.

Copeland's Privacy Statement for U.S. Consumers lets you know how we handle personally identifiable
information you share with Copeland through our customer call centers. It also applies to personal
information we obtain for marketing purposes from Copeland affiliates and Copeland representatives.

We will not share your personal information with other third parties for their independent use without your
permission.
Contact Copeland
Your Name
Company
Phone Number
E-mail Address
Address
City
State/Province
Postal Code
Country
Fax
Valve Information
Quantity
End Dimensions, inches
ANSI Pressure Class
Reduced Port
Full Port
 Port Size
Other
Pipe Size/Schedule
Piping Material
End Connection
Materials of Construction
Special Features
Application Information
Pressure, Design
Pressure, Max Operating
Bi-directional flow?
Media
Required Cv
Actuation Information
Actuation Type
Manufacturer
Open
 Closed
Last
Actuator Fail Position
Air/Hydraulic/Electrical/ Supply
Electrical Requirements
Other Accessories
Estimated Order Date
Special Instructions
Customer Delivery Requirements
New Installation? Please describe.
Copeland
Severe Service Ball Valves