Stem Extension Worksheet "*" indicates required fields Job Name/Reference*Date* MM slash DD slash YYYY Contact Information:Name* First Last Title*Company*Email* Address* Street Address City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÃ…land Islands Telephone*FaxApplication (attach sketch)*Sketch*Max. file size: 50 MB. Valve* Ball Butterfly Gate Diaphragm Multiport1 90° Multiport1 180° Valve Size*Length from centreline of valve*Centreline Top/Bottom* To top of operator To bottom of operator Valve/Piping Orientation* Horizontal Vertical2 Shaft Material* 304 SS 316 SS Housing Material* 304 SS 316 SS PVC No Housing Options Gear operator3 (if different from standard operator) Gear operator3 on valve Gear operator3 on valve for submersion Gear operator3 on valve for burial PVC wall bracket/support (non-housed extensions) 3' Floor stand/Pedestal4 3’ removable floor stand/pedestal for use with butterfly valves and in-ground valve box. 1 If using without housing, no travel stop available; if using with housing, advise if for 90° or 180° operation 2 Requires gear operator on valve 3 Housing, if used, must be metal 4 Only used on extensions with no housing, and on top of a valve/works vault. Other applications, such as with housing, will be fabricated to end 3 feet above ground level.Valve Configuration*Select a configuration *Piping vertical / extension vertical / no housingPiping vertical / extension vertical / with housingValve horizontal / extension vertical / no housingValve horizontal / extension vertical / with housing LengthLength from valve centerline*from valve centreline to theTop or Bottom of Operator*selecttopbottomof operator, to the nearest 12mm or 1/2" Required gear operator, direct mounted to butterfly valves, but with bracket for ball, gate, diaphragm and multiport valves Requires flanged gear operator, direct mounted to butterfly valves, but with bracket for ball, gate, diaphragm and multiport valves Extension mounted to valve shaft.Requires independent support of stem extension to remain in place. Extension mounted to valve shaft.Housing attached to top of valve.Requires extra support if extension is over 20 feet.Privacy Policy and Data Usage Policy Acknowledgment ** Yes, I have read the privacy and data usage policy and would like to continue. * required field