Florida Pipe Freezing


Company Name
Billing Address
City, State, Zip
Contact Name
Office phone	() -
Cell Phone #	() -
Fax	() -
E-mail Address
Job Name
Job site Address
Purpose of Freeze
Pipe Size
Pipe Type (steel, copper, ductile, etc.)
System Type (Chilled Water, Condenser Water, Fire Sprinkler, Domestic Water, Fuel Oil, Glycol, or other)
How many ice plug(s) in vertical lines
How many ice plug(s) in horizontal lines
What is the total # of Freeze Jackets required
How long will the ice plug(s) need to be held?
When is job to be done? (Day, Night, Weekend & approx. Start Time if known)
Job site Conditions (Construction, mechanical room, finished / occupied area)
Elevation of Pipe
Feet of straight pipe where jacket is to be placed?
How close will jacket be to any branch connections?
How close will cutting or welding be to the freeze jacket?
How close together will the freeze jackets be in relation to one another?
Gaseous Nitrogen will be piped to a well ventilated area. How far is it to the nearest open air space?
What floor is the work on?
Is there an elevator to floor level of work for Dewars?
How close can our work truck(s) get to the work space? (9' clearance req.)
Other pertinent information

WATERS MECHANICAL, INC.