Fernstrum GRIDCOOLER - Page 23

Installation and Maintenance Manual form 185
Page 21
11.0 RECOMMENDATION FORM
R.W. Fernstrum & Company • P.O. Box 97 • Menominee, Michigan 49858
Phone: 906.863.5553 • Fax: 906.863.5203 • Email: sales@fernstrum.com
R.W. Fernstrum & Company • P.O. Box 97 • Menominee, Michigan 49858
Phone: 906.863.5553 • Fax: 906.863.5203 • Email: sales@fernstrum.com
FORM R13
RECOMMENDATION FORM
*Required Information
R.W. Fernstrum & Company
EMAIL: sales@fernstrum.com
PHONE: (906) 863-5553  FAX: (906) 863-5203
PO Box 97  1716 11
th
Avenue  Menominee, MI 49858 USA
FERNSTRUM® and GRIDCOOLER® are registered trademarks of R.W. Fernstrum & Company.
Data contained herein is confidential and proprietary to R.W. Fernstrum & Company and may not be used, disclosed, reproduced, modified, performed, or displayed
without prior written approval of R.W. Fernstrum & Company
.
COMPANY NAME*__________________________________________________________________________
CONTACT NAME* __________________________________________________________________________
ADDRESS__________________________________________________________________________________
CITY, STATE, ZIP CODE _______________________________________________________________________
COUNTRY _________________________________________________________________________________
PHONE* ________________________________________ FAX______________________________________
EMAIL* ___________________________________________________________________________________
VESSEL NAME / PROJECT NAME________________________________________________________________
PRODUCT DESIRED* GRIDCOOLER® Keel Cooler  BOXCOOLER 
ENGINE TYPE* Propulsion  Bow Thruster  Generator  Other________________________
Emissions Data Tier 1  Tier 2  Tier 3  IMO 
Manufacturer*_____________________________________________________________________________
Model* ___________________________________________________________________________________
Rating (
BHP / RPM, BKW / RPM, EKW / RPM)*_______________________________________________________
Minimum Hull Speed at Full Rated Power (under full load)* _________________________________________
Maximum Sea Water Temp*_________________ Engine Age_________ % Antifreeze Used*___________
Make & Model of Gear_______________________________________________________________________
Type of Boat (ferry, trawler, pleasure boat, etc.)*__________________________________________________
Hull Construction* Steel  Fiberglass  Wood  Aluminum Painted 
Cofferdam Installation  Aluminum Unpainted 
Heat Rejection______________________________________________________________________________
Fresh Water Flow Rate_______________________________________________________________________
Fresh Water Temp into Cooler_________________________________________________________________
Fresh Water Temp Out or Drop Across Cooler__________________________________________  Drop
 Out
Comments
section 11 RECOMMENDATION FORM
installation and maintenance manual form 170 page 19
RECOMMENDATION FORM
ENGINE INFO
TYPE Propulsion  Bowthruster  Generator  Other
MANIFOLD Wet  Dry 
Make
Model
HP & RPM
Heat Rejection
Fresh Water Flow Rate
Fresh Water Temp into Cooler
Fresh Water Temp Out or Drop Across Cooler
Minimum Hull Speed at Full Rated Power under full load) (If Speed is
0 knots, or the engine is used as a generator size for 1/2 mph)
Maximum Sea Water Temp Engine Age % Antifreeze Used
Make & Model of Gear
Type of Boat (ferry, trawler, pleasure boat, etc.)
Hull Construction Steel  Fiberglass  Wood  Aluminum 
Comments
CUSTOMER
PHONE
FAX
E-MAIL
Date
Initials
 Drop
 Out
 Painted
 Unpainted
Maintenance Manual 7/10/12 10:12 AM Page 23
section 11 RECOMMENDATION FORM
installation and maintenance manual form 170 page 19
RECOMMENDATION FORM
ENGINE INFO
TYPE Propulsion  Bowthruster  Generator  Other
MANIFOLD Wet  Dry 
Make
Model
HP & RPM
Heat Rejection
Fresh Water Flow Rate
Fresh Water Temp into Cooler
Fresh Water Temp Out or Drop Across Cooler
Minimum Hull Speed at Full Rated Power under full load) (If Speed is
0 knots, or the engine is used as a generator size for 1/2 mph)
Maximum Sea Water Temp Engine Age % Antifreeze Used
Make & Model of Gear
Type of Boat (ferry, trawler, pleasure boat, etc.)
Hull Construction Steel  Fiberglass  Wood  Aluminum 
Comments
CUSTOMER
PHONE
FAX
E-MAIL
Date
Initials
 Drop
 Out
 Painted
 Unpainted
Maintenance Manual 7/10/12 10:12 AM Page 23