GREEN ACCESS & FALL

PROTECTION EQUIPMENT
Application Data Sheet

R.F.Q.#: __________________________________________________________
Company: ________________________________________________________
Name & Title: _____________________________________________________
Address: _________________________________________________________
City: ____________________ State: _______ Zip: __________ Country: ______
Telephone: _________________________ Fax: __________________________
E-mail: ___________________________________________________________
Budgetary Firm
Project Location: ___________________________________________________
Project Scope: ____________________________________________________
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Additional Information Attached Description: _________________________
Requirement For All USA Made Material
Loading Arm Involvement
Sealed / Food Grade Welding Require

(OSHA Regulations will be followed unless otherwise noted)

Customer Signature: __________________________ Date: ________

Salesman Signature / Number: __________________ Date: ________
BENKO PRODUCTS, INC.
5350 Evergreen Parkway
Sheffield Village, OH 44054
(440) 934-2180
Fax (440) 934-4052
www.green-mfg.com
Email: [email protected]
 FOR NEW LOADING RACK
Questions below are for a strait, uniform width platform.
For other conditions, please submit sketch.

A. Platform Length = ___________________ H. Walk Surface

B. Platform Height Serrated Bar Grating (STD)
10’8” 12’ 15’4” Other ____________ Grip Strut
C. Platform Width = Fiberglass Grating
3’6” 4’ 5’ Other ____________ I. Canopy
D. Access Stairs Full Half No Canopy
1) Material Finish - Structural Members
1 End Both Ends
Number of stairs at other locations (perpendicular to Steel
Main axis of platform): _______________ Mill Finish Galvanized Primed
(NOTE: Stairs at 45° angle unless noted) Finish Painted (Provide paint specs. & prep)
E. Number of Cage Ladders: __________ Yellow Gray
(Note Location) Black Other ________
F. Platform Supports
2) Material - Roofing
Pedestal 2 Leg Supports / Bent
29 Gauge Galvanized
G. Material / Finish Option: FRP
Aluminum (Specify Style & Color)
Mill Finish
Epoxy Coated ——————————————————-
_________________________________
Yellow Gray Black Other ________ _________________________________
Steel _________________________________
Mill Finish Galvanized Primed
Finish Painted (Provide paint specs. & prep)
Yellow Gray Black Other ________

ACCESS EQUIPMENT
A. SAFETY BRIDGE/STAIRS 4. Type of Mount
1. Type Standard
SS200/400 SB300/500 SB300RT/500 Top Mount
To be Determined Flush Mount
2. Material / Finish Pivot
Aluminum Standard
Mill Finish Epoxy Coated Elevating
Yellow Gray Black Other _____ “Hemco” Retrofit
Material / Finish
Steel
Mill Steel Primed Steel Galvanized Steel
Mill Finish Galvanized Primed
Painted (Provide paint specs & prep) 5. Options
Self-leveling Hoop
Yellow Gray Black Other _____
4’ x 6’ 6’ x 6’
3. Width Hoop Height
24” (STD) 18” (NAR) 30” 36” 48” 6” 18” 33” Other ________
Other ________
 Track Mount C. HOPPER CAR/TRUCK HANDRAIL SYSTEM
A. Material 1. Length = __________________
Finish Painted (Provide paint specs & prep)
2. Fixed Elevating
Primed Steel
3. Material/Finish
Galvanized Steel A) Handrail
Mill Steel Aluminum
B. Type of Handrail
Mill Finish
Chain Openings
Epoxy Coated
Swing Gates
Yellow Gray
Track Mounted (Unless noted, handrail will be
steel construction) Black Other ________
Steel
Modified Stored Position (80 PSIG-STD)
Mill Finish Galvanized Primed
Sea Container Tread
Finish Painted (Provide paint specs & prep)
Air Assist Operation (80 PSIG-STD)
Yellow Gray
(Other systems available - Advise PSIG _______)
Black Other ________
Hydraulic Operation Manual Operation
B) Supports
Power Operation
Mill Finish Galvanized Primed
6. Modifications: ______________________________ Finish Painted (Provide paint specs & prep)
_____________________________________________
_____________________________________________ Yellow Gray
_____________________________________________ Black Other ________
_____________________________________________
4. Optional Access Platform with:
SB300RT/500RT Bridge
B. SAFETY SYSTEMS
1. Type/Series 5. Power Pack Option *
SS200HS/400HS SB300HS/500HS
D. ELEVATING PLATFORMS
2. Length = _______________
1. Machine Screws (STD)
3. Material/Finish (Other systems optional. Advise PSIG _________)
Aluminum 2. Length = _________________
Mill Finish Galvanized Primed
3. Material/Finish
Finish Painted (Provide paint specs & prep)
Aluminum (Platform only)
Yellow Gray Black Other _____
Mill Finish
4. If enclosure is longer than platform (or over Epoxy Coated
hangs the end), indicate length of overhang at Yellow Gray
each end: ___________________________
Black Other ________
5. Options Steel
Modified stored position (STD 80°)
Mill Finish Galvanized Primed
Other _______________
Finish Painted (Provide paint specs & prep)
6. Power Pack Option * Yellow Gray
7. Modifications: ____________________________ Black Other ________
_________________________________________ 4. Options
_________________________________________
Spring Operated Gangway
_________________________________________
_________________________________________ With Swing Gates
Flip Up Panels
5. Power Pack Option*
* POWER PACK OPTION *
Single Station
Double Station
Non-Explosion Proof
Explosion Proof:
Class _____________
Division _______________
Electrical Requirement
Single Phase
Three Phase
Voltage ____________
Air Driven Pump, Explosion Proof
Cylinder - Rod Boot Covers
Special Material ____________________________
___________________________________________
___________________________________________
 LOADING ARMS
Note riser location, quantity, etc. on vehicle & platform plan views.

Quantity of Arms ___________________ Type of Requirement

Riser Orientation Top Loading
Upfeed Downfeed Horizontal Top Unloading
Material to be transferred Bottom Loading
Product ____________________________________ Bottom Unloading
Temperature _______°F Viscosity ___________SSU Preferred Metals
Concentration (If applicable) ____________________
All Parts Carbon Steel
Metals & Seals now used to handle
Product __________________________________ Carbon Steel & Aluminum
Type of Vehicle All Parts 316 Stainless Steel
Tank Truck Railcar 316 Stainless Steel & Aluminum
Other type of loading (drums, etc.) ______________ Non-Ferrous Metals
____________________________________________ Preferred Seals
Sizes and Capacities Viton
Pipe Size _________ Vapor Pipe Size _________ Buna-N
Max PSIG ________ Discharge Rate ________GPM Food Grade Neoprene
Working PSIG ___________
Teflon
Features
Will arm need to offer flexibility for vehicle mis- Not Known
spotting? Other ________________________________
Yes No Spotting Allowance ± ________FT ____________________________________
Will arm serve both sides of platform? Preferred Balancing Method
Yes No Spring
Splash Loaded Right Hand Left Hand
Submerge Tight Fill Counterweights
If tight fill, specify size & type of tight fill connection: Other ________________________________
_________________________________________ _____________________________________
_________________________________________ Special Requirements for Arm
Is a loading valve required in the loading arm? Steam Jacketing
Yes No X-Ray
If valved loader, specify size, preferred type and
valve location: _____________________________ All Welded Construction
_________________________________________ High Level Sensor
If valved loader, will arm retain product? Other __________________________________
Yes No _______________________________________
Vapor Recovery Equipment by Others
Yes No (Specify Weight & Location)
Vapor Recovery Attachment Electrical Tracing ______________ LBS/FT
Inflatable Hatch Seal Insulation _______________LBS/FT
Cover Plate Hose __________________________________
Tapered Hatch Plug Valve __________________________________
None (Specify size & type of connection on end of Other __________________________________
vapor line _ _______________________________________
 These are typical representations. Note actual configurations if different.
9’ 0”

45”

3’ 6”

22’ 0” 13’ 6”

1’ 0”
18’ 0” 9’ 6”

TOP OF
GRADE
TOP OF
RAIL
4’ 0”

8’ 6” 8’ 0”

17’ 0”

STANDARD RAILROAD ENVELOPE STANDARD TRUCK ENVELOPE

MAX.
MAX.
TO
TO
MIN.
MIN.

MAX. TO DIA.
MAX.
TO
TO
MIN.
MIN.

TOP OF TOP OF
GRADE GRADE

SEA CONTAINER TANK/HOPPER TRUCK

MAX. MAX.
OFFSET HATCHES
TO TO

MIN. MIN.

MAX.

MAX. TO

TO MIN.

MIN.

TOP OF TOP OF
RAIL RAIL

TANK CAR HOPPER CAR

 Note any obstructions that may interfere
Full Canopy = 27’ 0”
With access equipment operation
Half Canopy = 19’ 6”
Other______________

Overhead
Clearance

T.O.G. EL.

Tank Truck Tank Truck

Tank Car Tank Car
Hopper Car Hopper Car
Hopper Truck Hopper Truck
Sea Container Sea Container

Platform
Top of Grade Height Top of Grade
(EL. ________) (EL. ________)
Top of Rail
B.O.S. EL.

SIDE “A” SIDE “B”

Foundation Height
ELEVATION VIEW
All truck centerlines
Should allow a spotting
Fill out dimension information
Variance of 6” ± on all vehicles served
on vehicle data sheet

FOR EXISTING LOADING RACK

Identify (X) which member / grating configuration
matches your platform and fill in correct sizes.

Grating Size ________________________________ Grating Size ________________________________ Grating Size ________________________________

Material Finish ______________________________ Material Finish ______________________________ Material Finish ______________________________
Member Size _______________________________ Member Size _______________________________ Member Size _______________________________
(DEPTH & FLANGE WIDTH) (DEPTH & FLANGE WIDTH) (DEPTH & FLANGE WIDTH)

Grating Size ________________________________ Grating Size ________________________________ Grating Size ________________________________

Material Finish ______________________________ Material Finish ______________________________ Material Finish ______________________________
Member Size _______________________________ Member Size _______________________________ Member Size _______________________________
(DEPTH & FLANGE WIDTH) (DEPTH & FLANGE WIDTH) (DEPTH & FLANGE WIDTH)