Air Scrubbers USA

For Serious Gas, Chemical and Particle Control Air Scrubbers USA
Information Help Line 800-868-0964

   
Product Query/Quote
Please print and Fax to: 952-448-5207
Date:
Name of Rep/Account Executive:
Company Name: Email: Tel:
1. Space Information  
Type of Area
Industrial Commercial Retail Office
Space Size
ft. long ft. wide
square ft.
Ceiling Height
ft. high
Usages
Manufacturing
Warehouse
Lab
Other:
Fill Factor
% estimated percentage of room contents' volume displaced by physical objects
Suspended Ceiling
Yes No
ft. between ceilings
2. Air Filtration On Premises Information  
HVAC
Type: # of Units: # of Inlets: # of Returns:
Size or Ducts:    Heater/Fan Specs:
Chemicals
Chemical Name: by-product of: Chemical Name: by-product of:
Particles
Type: PPM: Size: Source: Size:
Type: PPM: Size: Source: Size:
Odors
Type: Discomfort Level: Strong Medium Mild
  Source:
Type: Discomfort Level: Strong Medium Mild
  Source:
Microbial
Viruses Bacteria Mold Allergens Other (Specify Below)
   Type: Extent:
   Type: Extent:
3. Space Occupant Information  
People
Number of People:      Functions of People:
4. Space Occupant Information  
Materials
Explosive Materials: Yes No    Type:
Flammable Materials: Yes No    Type:
Hazardous Materials: Yes No    Type:
MSDS (Material Safety Data Sheets) for sections 2 & 4: Yes No
5. Operational Type  
Operation Type
Liquid to Vapor Solid to Dust
Point of Discharge Collection
Yes No
Duration
Per Day: 4 hrs 8 hrs More wk/mo
6. Product Query  
Do you have a specific Electrocorp product in mind?

Yes   Please specify:        No
7. Process Information  
Process Explanation
8. Specific Requirements  
Negative Pressure Needed
Yes No
Needed by
Budget
Yes No Amount:
9. Company Requesting Information  
Company Information
Company Name: Address: City: Province/State: Country:
Contact Person
Last Name: First Name: Title:
Telephone: Extension: Fax: Email Address:
10. Additional Comments  
Process Explanation

Please print and Fax to: 952-448-5207

 

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