Note: All Required Fields are Marked with an Asterisk(*).
1. Company Name:
2. Your Name:
3. Email Address:
4. Street Address:
5a. City:
5b. State:
Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Col. Flordia Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming *
5c. Zip Code:
6. Country:
7. Phone Number(s):
8. Fax Number(s):
9. If you know the model number you are
10. What is the application of the air cleaner?
Industrial Commercial Residential
11. Type of air cleaner interested in:
Mechanical Electronic
12. Air Cleaner Design Choice:
Select Design Forced air ductwork Self-contained
13. Installation Placement of Air Cleaner:
Select Installation Floor Mounted Ceiling Suspended
14. What is the air flow direction?
Select Air Flow Horizontal Vertical Vert. in Horiz. out Not Sure
15. If the air cleaner is for in duct application,
A/C tonnage 3 /min
16. For other applications:
A/C tonnage 3 /min
17. Dimensions of room to be cleaned:
LxWxH
18. Allowable pressure drop of system:
19. Environment of air cleaner:
Select Environment Indoors Outdoors
20. Number of air changes required:
21. Particulate Type:
22. Particulate Size:
23. Particulate Density Measurement:
24. If particulate medium is not air, enter
25. What is the temperature of air/gas medium:
26. Power Available: Voltage Hz Phase
27. Electrical Class:
28. If any special motor type is
29. Does the air cleaner need to be:
30. Automatic wash controls are:
31. Detergent injection during wash is:
32. Are pre- or post filtration plenums
33. Are any controls, features, accessories
34. Are there any other specifications
