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Certified Company


Please Read the Procedure Before Filling Out This Form In Order To Speed Up The Process Of Application:

 

Application Approval Form

Answer questions with “Unknown” or 0 (Zero) when the information is not available

CUSTOMER INFORMATION
Name:
Date:
Company:
Address:
City:
State:
Zip Code:
Country:
Telephone:
Fax:
Email:
(Copy of Form will be sent to)
APPLICATION VEHICLE INFORMATION
Program I.D.: No. of Trucks in the program:
Type of Truck:  
  No. of Axles:
No.of Tires: Single: Dual:
 
Air Compressor Output: CFM @ RPM PSIG@ RPM
Air Dryer Capacity: CFM
Power:  
   
Liters
Cu Ft :
Empty Tire Volume:
CTI Axle Make & Model (Front):
CTI Axle Make & Model (Rear):
   
mm
in
Approximate Hub Air Passage Size (Front):
Approximate Hub Air Passage Size (Rear):

 

CTIS INFORMATION
CTIS FEATURES
YES
NO
 
Priority Pressure Switch:
 

Auto Upgrade of Tire Pressure (Over speed):

 

CTIS with J1939 CAN BUS:

 
   
Pulses/Mile
Pulses/Km
Speed Signal Rate:
Speed Signal Shared With Speedometer:
 
Speedometer Circuit Load Impedance: Ohms (Typically 100 Ω)
DESIRED CTIS OPTIONAL FEATURES:
 
YES
NO
Load Select:
 
Manual Run Flat:
 

Blackout Mode:

 
   
Single
Dual
Number of Channels Required:
Number of Tires per Channel 1:
Number of Tires per Channel 2:
Communication Protocol & Interface RQD:
 
YES
NO
J1708:
 
RS485:
 
RS232:
 
Multifunction Switch:
 

CTIS INTERCONNECT HARNESS INFORMATION

General Info    
YES
NO
One-piece Harness (CTIS Controller to Manifold):
   
Length
 
Ft
Mts
One-piece Harness (CTIS Controller to Manifold):
First piece of two-piece harness (CTIS Controller to Bulkhead):
Second piece of two-piece harness (CTIS Manifold to Bulkhead):
 
 
 
Table 1
Single Channel Speed Limit And Tire Pressures
When Ordering CTIS Load Select Feature.
Please specify the type of unit measurements you are providing
 
M/Hr
Km/Hr
Speed Limit Type:

 
PSI
BAR
Tire Pressure Type:
Terrain
Speed Limit
Empty Load
Tire Pressure
Half Load Tire Pressure
Full Load Tire Pressure
Highway
X-Country
Mud/Sand/Snow
Emergency

 
Table 2
Single Channel CTIS Speed Limit And Tire Pressures 
When Not Ordering  CTIS Load Select Feature
Please specify the type of unit measurements you are providing
 
M/Hr
Km/Hr
Speed Limit Type:

 
PSI
BAR
Tire Pressure Type:
Terrain
Speed Limit
Single Channel
Pressure
   
Highway
X-Country
Mud/Sand/Snow
Emergency
 
Table 3
Dual Channel CTIS Speed Limit And Tire Pressures 
When Not Ordering  CTIS Load Select Feature
Please specify the type of unit measurements you are providing
 
M/Hr
Km/Hr
Speed Limit Type:

 
PSI
BAR
Tire Pressure Type:
Terrain
Speed Limit

Dual Channel

Pressure
 
Channel 1
Channel 2
Highway
X-Country
Mud/Sand/Snow
Emergency
 
Table 4
Dual Channel CTIS Speed Limit And Tire Pressures 
When Ordering CTIS Load Select Feature
Please specify the type of unit measurements you are providing
 
M/Hr
Km/Hr
Speed Limit Type:

 
PSI
BAR
Tire Pressure Type:
Terrain
Speed Limit
Channel 1
Channel 2
 
Empty
Half
Full
Empty
Half
Full
Highway
X-Country
Mud/Sand/Snow
Emergency

 

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