Rotrex Winches Customer Enquiry Form

Company Name

Contact Name

Telephone No.

Email Address

Delivery Date

Length of Hire

Site Address

Notes

Is the winch required for pulling, lifting or man-riding?

Please Choose...pullingliftingman-riding

Winch type required? (e.g. base mounted, trailer etc.)

What size winch is required?
(What is the safe working load/pulling or lifting capacity)

What rope length is required? (Please specify in metres)

What power supply is available?

Is a data recorder required?

YesNo

Is a drop leg boom required?

YesNo

If the drum is over 5T do you require a site or road going trailer?

Please Choose...SiteRoad

Are you towing on the road?

YesNo

Drum diameter? (Please specify in mm)

Drum width? (Please specify in mm)

Drum weight? (Please specify in kg)

Spindle hole diameter? (Please specify in cm)

Cable rollers type?

Cable rollers quantity?

Cable lubricant (20L buckets)

Cable drum stands (If so, how many?)

Cable stockings (Diameter of cable? Please specify in cm)

Bellmouth’s - (Internal diameter of both ends required).
Internal diameter 1 - (Please specify in cm)

Bellmouth’s - (Internal diameter of both ends required).
Internal diameter 2 - (Please specify in cm)

Conduit rod/Cobra - (Both length & diameter required).
Length - (Please specify in cm)

Conduit rod/Cobra - (Both length & diameter required).
Diameter - (Please specify in cm)

Any other items required?