Draft King® Custom Chase Cover Order Form

HY ‐ C CHASE COVER ORDER FORM 1 ‐ 800 ‐ 325 ‐ 7076 Fax: 314 ‐ 241 ‐ 2277

Customer Name:_____________________

Homeowner's Name/Job No:________________

City, State, Zip:______________________

Phone:___________________________

E ‐ mail Address:______________________

Metal Type:

Galvanized

Stainless Steel

(Circle metal preference above)

Please give all dimensions to the nearest 1/8".

Complete this section for all Chase Covers. A. Perimeter Dimensions: 1. Length (longest side)__________

2. Width (going clockwise from 1)__________ 3. Length (going clockwise from 2)_________ 4. Width (going clockwise from 3)__________

B. Height of Skirt (3"standard):_________ C. Standard Collar height is 2".

SINGLE ‐ HOLE CHASE COVERS

A. Hole Diameter:__________ B. Distance to hole from sides. A1________

A2________ A4________

A3________

C. Storm Collar:_____Yes

_____No

If Yes: Pipe OD Size_______

TWO ‐ HOLE CHASE COVERS

A. Hole Diameter: A:______ B:______ B. Distance to Hole from sides A1_______ A2_______ A3_______ A4_______

B1_______ B3_______

B2_______ B4_______

C. Storm Collar(s):_____Yes

_____No

If Yes: Pipe OD Size_______

HY ‐ C will add up to 1/4" to reported Perimeter Dimensions to ensure fit/clearance. Hole Diameters will be made 1/2" larger than reported to ensure fit/clearance.

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