TO OBTAIN A PILE SPLICE QUOTATION:

PLEASE PROVIDE THE FOLLOWING INFORMATION (If a standard FDOT or LA DOTD pile only fill in the first 7 lines).
Please fill in this form. You can then print to Send by Fax or Scan to Email. Thanks for your enquiry.

	DATE:
YOUR COMPANY:	LOC'N:
YOUR NAME: Title:	PROJ:
PHONE:  FAX: Cell:	EMAIL:
PILE SIZE: Sq.          Oct.,        or Other
QUANTITY OF SPLICES: Pairs (= 1pr./joint),    TEST PILES INITIALLY?
DELIVERY POINT: (e.g., state, city,port, etc.)
DELIVERY POSSIBLY NEEDED WHEN?
NO. & SIZE OF STRANDS and/or REBAR: Qty.,    Dia.
CONCRETE STRENGTH f 'C = psi   SPIRAL/CONFINEMENT.: Dia./Wire Size
SPLICE STRENGTH REQUIREMENTS:
Full pile strength as calculated by strand capacity in Tension and by PCI Interaction Diagram for Moment.
Tu = Kips (kN) @ Mu = 0, and/or Mu = k-ft. (kN-m)@ Tu = 0
Tu = psi driving stress (700, 1000, 1200 e.g.), no specified service load
Don't know/ to be determined / will have to discuss
(Cost of splice is usually determined by moment requirement, if spec'd at full pile capacity.)
LOCATION OF STRANDS (and/or rebar) center to center, & PILE (form) DIMENSIONS:
Strand centerline is size of pile – (cover X2) – (spiral dia X2) – strand dia = in or mm
			(Compute & Fill-In)
Glenn Lockie,  PILE SPLICES, INC.,  264 Cazneau Ave., Sausalito, CA 94965 USA                                                                      Ph: 415-331-7260 •  Fax: 415-331-7261

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