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Date
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MM
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DD
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YYYY
Company Name
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Contact
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Purchase Order No.
Phone
*
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Fax
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Email
Axle Combination
*
Single
Tandem
Triple
Number of Axles needed
*
Type Requesting
*
Axle beam only
Complete Axle assembly inc. Hub / H&D
Axle Serial Number
Stamped on the rear side of the axle
Axle Model
*
Axle Model
D20 (1,000-2200)
M-22 (2,200 2 X 2 X .180 Sq Tube Galvanized)
D35 (2,300-3,500)
M-35 (3,500 2 X 2 X .250 Sq Tube Galvanized)
D44 (4,400)
D52 (5,200)
D60 (6,000)
D70 (7,000)
D72 (7,200)
D80 (8,000)
D90 (9,000)
D100GD (10,000)
D100HD (10,000)
D120HD (12,000)
D150HD (15,000)
Axle Weight Capacity
*
Tube Diameter
*
Hubface (Single Wheel)
Track Width (Dual Wheel)
*
Spindle Location
*
Straight
4" Drop
6" Drop
Type of Lubrication
*
Grease
Oil
Nev-R-Lube
Hub / Hub & Drum No.
Inner Bearing No.
*
Outer Bearing No.
*
Seal I.D. / O.D. or No.
*
Wheel size
*
n/a (Axle beam orders only)
8" - 12"
13" - 15"
15"+
Idler or Brakes
*
Idler or Brakes
Idler hub
Electric brakes
Hydraulic Brakes
Disc Brakes
Air Brakes
Idler axles do not come with brake mounting flanges
Hydraulic, Electric or Air Brake Size
*
If idler type "none"
Hydraulic Brake options
Free Backing
Uni-Servo
Duo-Servo
Disc Brakes
Electric Brake options
Manual Adjust
Self Adjust
w/Parking Brake
Spring Type
Double Eye
Slipper
None
Spring Width
N/A
1.75"
2.00"
2.50"
3.00"
Spring Number
Type "none" of you do not want springs
Spring Position
*
Overslung (Springs located above Axle)
Underslung (Springs located below Axle)
Loose pads
Spring Centers
*
Type "Loose" if you do not want the spring seats pre-installed
Options
ABS
Wired
E-Z Lube (Included with M-22,M-35 Axle Beams)
Brake Flange (included with complete brake axle assembly)
Automatic Slack Adjusters
30/30 Chambers
Parking Brake
Shock Brackets
Shock Absorbers
Lo-Profile Hub for 14.5" wheel (D120 Axle)
Marine Galvanized Axles (D20-D70 Axles)
Stainless Steel Wear Sleaves on Gav. Axles
V-Bend
2.38" Tube (Option for D20 Axle)
3" Tube w/ LT Wall (Option for D35,D52 Axle)
3" Tube w/ Med Wall (Option for D35,D52 Axle)
3" Tube w/ Hvy Wall (Option for D52 Axle)
3.5" Tube w/ .50 Wall (D70,D80 Axle w/Air Ride)
5" Tube w/ Hvy Wall (D90 Axle w/Air Ride)
Single Axle Hydraulic Plumbing kit
Tandem Axle Hydraulic Plumbing kit
Bolt Circle (required if a complete axle assembly)
Bolt Circle
4 on 4
5 on 4.5
5 on 4.75
5 on 5
5 on 5.5
6 on 5.5
6 on 6
8 on 6.5
8 on 275mm Hub Piloted
UTG 5-Spoke
Stud Size (required if a complete axle assembly)
Notes
Acknowledgement of Liability
*
All measurements are accurate
All axles are custom made per customer specifications and are therefore non-returnable. Checking this box releases Leach Enterprises Inc. of any and all liabilities due to incorrect axle measurements, load ratings and/or injuries due to improper application. Axles must be prepaid before they can be ordered from the manufacturer.
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