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Position/Title:

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Street Address:

Town/City:

State:

Postal Code/Zip:

Country:

Country Telephone Code:

Telephone City/Area Code:

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Number of Units Needed:

Type of Facility and Application for Air-Cleaning:

Explain Problem/Application:

Kinds of and sizes of particles in the air:

Dust Load:

HeavyMediumLight

Airflow Required:

Air Pressure Required:

Electrical Configuration:

Volts

Hertz

Phase

Are Dusts Hazardous? (Explosive):

YesNo

Classification of Hazardous Area:

Types of Corrosion Present: