Rotrex Winches Customer Enquiry Form

Company Name

Contact Name

Telephone No.

Email Address

Delivery Date

Length of Rental

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 feet)

What power supply is available?

Is a data recorder required?

Yes No 

Is a drop leg boom required?

Yes No 

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

Please Choose...SiteRoad

Are you towing on the road?

Yes No 

Drum diameter? (Please specify in inches)

Drum width? (Please specify in inches)

Drum weight? (Please specify in lbs.)

Spindle hole diameter? (Please specify in inches)

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 inches)

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

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

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

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

Any other items required?