Putnam Pipe Corp.

Submit an order online below or download the printable version for faxing!
Customer:			Contact:			Attention:
Purchase Order Number:			Office / Cell phone:			Today's Date:
Date Required:			Pick Up:		Delivery		AM	PM
	SDR35	SDR35	SDR35	SCH40	SCH40	S & D	S & D	PE
Size: (check boxes required)	4	6	8	4	6	4	6	4
Pallet Footage	630LF	520LF	390LF	480LF	200LF	900LF	350LF	100/250LF
Solid Pipe Pallet Quantities	SDR35		SCH40		S & D		PE Drain
Solid Pipe Less Pallet Quantity	SDR35		SCH40		S & D		PE Drain
Perf Pipe Pallet Quantities	SDR35		SCH40		S & D		PE Drain
Perf Pipe Less Pallet Quantity	SDR35		SCH40		S & D		PE Drain
Note: This form can be used for ordering multiple types of pipe, but only 1 fitting option. *Please submit a separate form for each type of fitting needed.
*Fitting Type:	SDR35		SCH40		S & D		PE Drain
Size:	1¼	1½	2	2½	3	4	6	8
90 Bend BB
90 Bend BS
45 Bend BB
45 Bend BS
22 Bend BB
22 Bend BS
Tee
Tee Wye
Coupling
C O Cap
C O Plug
SCR Plug
SCH/S&D ADPT
PVC Reducer
Misc. Items
Rubber Coupling	PVC/PVC		PVC/AC		PVC/Clay		PVC/Conc
	4x4		4x4		4x4		4x4
	6x4		6x4		6x4		6x4
	6x6		6x6		6x6		6x6
	8x6		8x6		8x6		N/A
	8x8		8x8		8x8		8x8
Other Size			Quantity
DI Swr Saddle	Romac CB4		Romac CB6		14.40 Strap		25.80 Strap
Rubber Saddle	DWF 4 Tee		DWF 4 Wye		DWF 6 Tee		DWF 6 Wye
Filters	Charcoal		Zabel 1801		Zabel A300
Flow Adjuster	Green		Gray		Dial A Flow		Silt Fence
PVC Cement	½ Pint		Pint		Quart		Hydraulic Cement
PVC Cleaner	½ Pint		Pint		Quart		Snow Fence
Lubricant	8 oz. Tube		Quart		Gallon
Marking Tape	Blue/Water		Green/Swr		Yellow/Gas		Red/Elec
Marking Paint	Orange		Blue		White		Yellow
Filter Fabric	360 x 3'		360 x 4'		360 x 12'		360 x 15'
Notes
	*Please enter your e-mail address:
All Material Pick Up and Deliveries are Subject to Stock Availability At the Time of Order .......................

90 Elm Street, Hopkinton MA 01748 | 508-435-3090| FAX: 508 435-5372

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